Nutrition in Head Neck Cancers

Öz

Nutrition is one of the factors that affect the morbidity and mortality in head and neck cancer. In these patients, adverse metabolic effects of cancer are seen in addition to the local factors associated with the tumor. Surgical intervention, radiotherapy and chemotherapy in head and neck region negatively affect the nutritional status. The main goal is to determine the need of nutritional support before treatment and provide it before, during and after the treatment. The head and neck cancer patients who have a body mass index less than 18.5 kg/m2, weight loss more than 10% within 3-6 months, limited oral intake more than 5 days and catabolic signs require nutritional support. Nutritional support is based on the ability of oral intake, the duration of the support and partial or total impairment of nutrition. Nutritional support with high protein ingredient, leucine or branched chain aminoacids and omega-3 fatty acids, high energy content (2 kcal/mL) are recommended for the patients with oral intake in addition to daily oral alimentation. In patients without oral intake, parenteral nutrition should be preferred for short term support while tube feeding should be preferred for long term support or home nutrition.

Anahtar Kelimeler

• Head and neck neoplasms
• diet food and nutrition
• malnutrition

BAŞ BOYUN KANSERLERİNDE NÜTRİSYON

Öz

Nütrisyon, baş ve boyun kanserli hastalarda morbidite ve mortalite üzerinde etkili faktörlerden biridir. Bu hastalarda kanserin neden olduğu olumsuz metabolik etkiler tümöre bağlı bölgesel faktörlere ek olarak gözlenir. Baş boyun bölgesine uygulanan cerrahi, radyoterapi ve kemoterapi tedavileri beslenmeyi olumsuz etkiler. Bu nedenle baş boyun kanserli hastanın tedavi öncesi beslenmesinin değerlendirilmesi, tedavi öncesi, sırasında ve sonrasında desteklenmesi gerekir. Baş boyun kanserli hastalarda beslenme desteğine ihtiyaç duyan hastalar vücut kitle indeksi 18.5 kg/m2’nin altında olan, 3-6 ayda %10 ve üzeri kilo kaybı olan, 5 gün üzerinde oral alımı azalmış ve katabolik etkilerin gözlendiği hastalardır. Planlanacak beslenme hastanın oral alımının olup olmadığı, beslenme desteğinin ne kadar süre gerekli olduğu ve besin alım sorununun kısmi veya total olmasına bağlı değişir. Oral beslenebilen hastalara gıda aralarında yüksek protein içerikli, lösin veya dallı zincirli aminoasitler ve omega-3 yağ asidinden zengin, yüksek enerji içerikli (2 kcal/mL) beslenme solüsyonları önerilir. Oral alımı olmayan hastalarda kısa süreli kullanımda parenteral beslenme, uzun süreli durumlarda veya evde hasta takibinde tüple beslenmeye geçilmelidir.

Anahtar Kelimeler

• Baş ve boyun neoplazileri
• beslenme desteği
• malnütrisyon

Kaynakça

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