| 1. |
- Silander, Ewa M, 1952, et al.
(författare)
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An exploration of factors predicting malnutrition in patients with advanced head and neck cancer.
- 2013
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Ingår i: The Laryngoscope. - : Wiley. - 1531-4995 .- 0023-852X. ; 123:10, s. 2428-2434
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Tidskriftsartikel (refereegranskat)abstract
- Malnutrition is common among head and neck cancer patients and negatively impacts on survival and quality of life. This study aimed to identify predictors of malnutrition at time of diagnosis in order to identify patients at risk and enable early nutritional support and prevent malnutrition.
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| 2. |
- Silander, Ewa M, 1952, et al.
(författare)
-
Energy intake and sources of nutritional support in patients with head and neck cancer-a randomised longitudinal study.
- 2013
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Ingår i: European journal of clinical nutrition. - : Springer Science and Business Media LLC. - 1476-5640 .- 0954-3007. ; 67, s. 47-52
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Tidskriftsartikel (refereegranskat)abstract
- Background/objectives:Malnutrition decreases the cancer patient's ability to manage treatment, affects quality of life and survival, and is common among head and neck (HN) cancer patients due to the tumour location and the treatment received. In this study, advanced HN cancer patients were included and followed during 2 years in order to measure their energy intake, choice of energy sources and to assess problems with dysphagia. The main purpose was to explore when and for how long the patients had dysphagia and lost weight due to insufficient intake and if having a PEG (percutaneous endoscopic gastrostomy) in place for enteral nutrition made a difference.Subjects/methods:One hundred thirty-four patients were included and randomised to either a prophylactic PEG for early enteral feeding or nutritional care according to clinical praxis. At seven time points weight, dysphagia and energy intake (assessed as oral, nutritional supplements, enteral and parenteral) were measured.Results:Both groups lost weight the first six months due to insufficient energy intake and used enteral nutrition as their main intake source; no significant differences between groups were found. Problems with dysphagia were vast during the 6 months. At the 6-, 12- and 24-month follow-ups both groups reached estimated energy requirements and weight loss ceased. Oral intake was the major energy source after 1 year.Conclusions:HN cancer patients need nutritional support and enteral feeding for a long time period during and after treatment due to insufficient energy intake. A prophylactic PEG did not significantly improve the enteral intake probably due to treatment side effects.European Journal of Clinical Nutrition advance online publication, 21 November 2012; doi:10.1038/ejcn.2012.172.
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| 3. |
- Silander, Ewa M, 1952, et al.
(författare)
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Impact of prophylactic percutaneous endoscopic gastrostomy on malnutrition and quality of life in patients with head and neck cancer - a randomized study.
- 2011
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Ingår i: Head & neck. - : Wiley. - 1097-0347 .- 1043-3074.
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The purpose of this randomized study was to examine if a prophylactic percutaneous endoscopic gastrostomy (PEG) for enteral nutrition could prevent malnutrition, reduce hospital stay, and improve health-related quality of life (HRQOL). METHODS: One hundred thirty-four patients with advanced head and neck cancer were randomized to either prophylactic PEG (study group) or clinical praxis (control group). Patients' weight, body mass index (BMI), need for hospitalization, and HRQOL were noted at 7 occasions during 2 years. RESULTS: No difference in hospital stay was found. After 6 months, HRQOL was significantly better and the weight loss was significantly less in the study group. The number of malnourished patients were consistently about 10% lower in the study group during the first study year. The study group started to use enteral feeding significantly earlier and for a significantly longer time period (p < .0001). CONCLUSION: Prophylactic PEG was associated with significantly earlier start and longer use of enteral nutrition, fewer malnourished patients over time, and improved HRQOL at 6 months posttreatment start. © 2011 Wiley Periodicals, Inc. Head Neck, 2011.
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