Managing Cachexia in Head and Neck Cancer: a Systematic Scoping Review
Mäkitie, Antti A; Alabi, Rasheed Omobolaji; Orell, Helena; Youssef, Omar; Almangush, Alhadi; Homma, Akihiro; Takes, Robert P; López, Fernando; de Bree, Remco; Rodrigo, Juan P; Ferlito, Alfio
(2022) Advances in Therapy, volume 39, issue 4, pp. 1502 - 1523
(Article)
Abstract
INTRODUCTION: Patients with head and neck cancer (HNC) are usually confronted with functional changes due to the malignancy itself or its treatment. These factors typically affect important structures involved in speech, breathing, chewing, swallowing, and saliva production. Consequently, the intake of food will be limited, which further contributes to loss
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of body weight and muscle mass, anorexia, malnutrition, fatigue, and anemia. This multifactorial condition can ultimately lead to cancer cachexia syndrome. This study aims to examine the treatment of cachexia in HNC patients. METHODS: We systematically searched OvidMedline, PubMed, Scopus, and Web of Science for articles examining the treatment of cachexia in HNC. RESULTS: A total of nine studies were found, and these suggested interventions including nutritional, pharmacologic, therapeutic exercise, and multimodal approaches. The nutritional intervention includes essential components such as dietary counseling, oral nutritional supplements, and medical nutritional support. Individualized nutritional interventions include oral, enteral (feeding tubes i.e., percutaneous endoscopic gastrostomy [PEG], nasogastric tube [NGT]) and parenteral nutrition. The pharmacologic interventions aim at increasing the appetite and weight of cachectic patients. Therapeutic exercise and increased physical activity can help to enhance the synthesis of muscle protein, reducing inflammation and the catabolic effects of cachexia syndrome. CONCLUSION: Owing to the multifactorial nature of this syndrome, it is expected that the management approach should be multi-interventional. Early implementation of these interventions may help to improve survival and quality of health and life of cachectic HNC patients.
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Keywords: Anorexia, Cachexia, Head and neck cancer, Sarcopenia, Systematic review, Pharmacology (medical), Review, Journal Article
ISSN: 0741-238X
Publisher: Springer
Note: Funding Information: Open Access funding provided by University of Helsinki including Helsinki University Central Hospital. The Sigrid Jusélius Foundation. The Helsinki University Hospital Research Fund. The Turku University Hospital Research Fund. The University of Helsinki Library funded the Open Access fees for the publication of this study. No funding or sponsorship was received for the journal’s rapid service fee for this article. The authors thank Dr. Carl Silver for his valuable editing of the English of the manuscript. All mentioned authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published. The study was conceived and designed by Antti Mäkitie. Alabi Rasheed and Omar Youssef performed the literature review. Alabi Rashed, Omar Youssef, Helena Orell, Alhadi Almangush, and Antti Mäkitie drafted the manuscript. Akhiro Homma, Robert Tekes, Fernando Lopez, Remco de Bree, Juan Rodrigo, and Alfio Ferlito were involved in commenting and revising the manuscript. All authors approved the final version. Antti A. Mäkitie, Rasheed Omobolaji Alabi, Helena Orell, Omar Youssef, Alhadi Almangush, Akihiro Homma, Robert Takes, Fernando López, Remco de Bree, Juan P Rodrigo, Alfio Ferlito all have nothing to disclose. This article is based on previously conducted studies and does not contain any new studies with human participants or animals performed by any of the authors. Data sharing is not applicable to this article as no datasets were generated or analyzed during the current study. Publisher Copyright: © 2022, The Author(s).
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