頭頚部がんの食事指導と栄養サポート

頭頚部がん患者における食事指導と栄養サポートの役割に関するレビュー論文を紹介します。

Platek ME. The role of dietary counseling and nutrition support in head and neck cancer patients. Curr Opin Support Palliat Care. 2012 Oct 4. [Epub ahead of print]

頭頚部がんにおける食事指導と栄養サポートのエビデンスは少ないです。しかし、診断時からリハ時まで、食事指導と栄養サポートの役割があることが示されています。革新的な栄養に基づいたケアも有効という報告があります。今後は栄養ケアの多施設での縦断研究とRCTが求められます。

抄録しか読んでいませんが、リハの時に食事指導と栄養サポートの役割があるというのは、リハ栄養的に嬉しいことです。特に悪液質を認める場合に、栄養サポートとリハが重要だと考えます。

Abstract

PURPOSE OF REVIEW:

Head and neck cancer patients frequently present with malnutrition. Treatment options put the patient at further nutritional risk. Inadequate nutritional status is associated with poor prognosis. Dietary counseling and nutrition support can positively impact prognosis; however, the evidence is sparse and of poor quality. The aim of this review is to summarize the current evidence concerning the role of dietary counseling and nutrition support in head and neck cancer patients undergoing curative treatment.

RECENT FINDINGS:

There remains a lack of evidence both in quantity and quality. Current findings support a role for dietary counseling and nutrition support from diagnosis through rehabilitation. Prognostic indicators for nutrition support include tumor location, tumor stage, and multimodal treatment. Results of an innovative nutrition-based care delivery model were positive.

SUMMARY:

Dietary counseling is appropriate for all head and neck cancer patients to enable adequate oral intake from diagnosis through rehabilitation; however, some patients require nutrition support. Prognostic indicators and predictive models have been developed to identify patients who require early nutrition support. Next steps include development of evidence-based nutrition care paths that are tested at multiple sites using well designed longitudinal studies and randomized clinical trials.