LAU WAI HONG1, NURUL HIDAYAH DEAN KAMARUDIN1, OOI JEE CHENG1
1 SUNWAY MEDICAL CENTRE
Up to 50% of head and neck cancer (HNC) patients who underwent concurrent chemoradiotherapy (CCRT) have significant dysphagia. Consequently, patients may experience weight loss due to lack of hydration and nutrition following their swallowing difficulties. The purpose of this study was to analyse weight change in HNC patients who had received early and structured dietetics and speech intervention during treatment in Sunway Medical Centre.
HNC patients on CCRT or radiotherapy were referred to dietetics and speech programme. A weekly joint sessions for 7 times, would be conducted by Speech-Language-Therapist (SLT) and Dietitian at outpatient setting. Assessment of nutrition status, weight change, swallowing, speech and voice were performed and followed by timely consultation and practical advice for patients and family/ caregivers.
Results & Discussion
72 HNC patients were referred to this programme. 50 patients (70.4%) were successfully recruited and 22 patients (29.6%) refused due to cost constraint. At the end of the programme, in interventional group, besides improving jaw, tongue, pharyngeal and laryngeal strength, 6% (n=3) showed weight gained, 20% (n=10) reported weight loss of 0-4.9%; 58% (n=29) loss 5-10%; 16% (n=8) loss more than 10%. Whereas in non-interventional group, 36.4% (n=8) weight loss 0-4.9%, 36.4% (n=8) loss 5-10% and 27.3% (n=6) loss more than 10%. Significant weight change (>10%) may require repeat immobilization shell, CT Simulation and re-planning of radiotherapy during treatment. After implementation of the programme, we received good feedback from both consultants and patients, especially nutrition outcomes and minimum interruption in treatment plan.
This programme helped HNC patients in interventional group to achieve less significant weight loss as compared to non-interventional group. Early and structured dietetics and speech-language therapy programme is important in improving patients' care and nutrition outcomes. Moving forward, comprehensive assessment of nutrition status and quality of life through the application of validated tools is required.