ESPEN 2012 - Late breaking abstract submission
Topic: Late Breaking Abstract
Abs n°:ESPEN12-1911
Abs Title: A NON-RANDOMIZED COMPARISON OF TUBE FEEDING OF ELEMENTAL DIET AND LOW RESIDUE DIET IN HEAD AND NECK CANCER PATIENTS DURING CONCURRENT CHEMORADIOTHERAPY
Y. Yajima 1,*T. Kobayashi 1H. Ishiki 1S. Kobayashi 2S. Suzuki 2R. Hayashi 3T. Akimoto 4M. Tahara 1
1Head and Neck Medical Oncology, 2pharmacology, 3Head and Neck Surgery, 4Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
Rationale: Oral mucositis is one of the most critical but unavoidable adverse events among head and neck cancer patients during concurrent chemoradiotherapy. Prophylactic percutaneous endoscopic gastrostomy (PEG) is well known supportive care to keep nutritional condition better for those patients but no nutrient has been proved to be more favorable than others. Here we investigated our patients if there are different effects on oral mucositis between those who nourished by low residue diet (LRD) and by elemental diet (ED), focusing on the glutamine, which is effective to prevent infection and repair mucous injury, and is contained only in the latter.
Methods: This is a retrospective, non-randomized comparison. The patients were locally advanced head and neck cancer who had started definite chemoradiotherapy between 1st July and 31st December 2011, with PEG in advance. They were stratified into two groups according to the kinds of nutrients given, LRD and ED respectively. The primary endpoint was the incidence of infection during the therapy and secondary endpoints were severity of oral mucositis, other adverse effects and body weight loss. Adverse effects were assessed by CTCAE version 4.0. The statistical differences were analyzed by Fisher’s exact test and Mann-Whitney U-test.
Results: The total number of the patients included in the analysis was 34, divided into two groups one with LRD nourished (n=20) and the other with ED (n=14). The incidence of infection was 30% in LRD group and 7.1% in ED group (p=0.20), the incidence of mucositis of grade 3 or more was 70% and 71% (p=1.0), and average body weight loss was 5.6% and 3.3% (p=0.10) respectively. Average glutamine intake per day was 4.8g in the ED group.
Conclusion: Glutamine may have positive effects on prevention of infection for head and neck cancer patients receiving chemoradiotherapy.
Disclosure of Interest: None Declared
Keywords: Head and neck canceroral mucositis