Review of the diagnosis and treatment of sarcopenia in patients with head and neck cancer
DOI:
https://doi.org/10.12873/443cacicedoKeywords:
Toxicidad, Supervivencia, Valoración nutricional, Ejercicio físico, SarcopeniaAbstract
Introduction: Patients with head and neck cancer can present tumors that originate in the mucosa and/or submucosa that lines the oral, pharyngeal and laryngeal cavities, giving rise to symptoms that usually affect swallowing and favor nutritional problems of these patients. Up to 52% of patients present malnutrition at diagnosis, increasing to nearly 90% during antineoplastic therapy. Therefore, they are one of the most vulnerable groups to develop sarcopenia associated with malnutrition and dysphagia. The objective is to review the current knowledge on the state of muscle mass, the pathogenesis, diagnosis and treatment of sarcopenia when it occurs in head and neck cancer.
Methods: bibliographic search in PubMed-Medline databases of articles between 2015 and 2022 with previously defined terms.
Results: Patients with head and neck cancer constitute a heterogeneous group in which the prevalence of malnutrition is significant but highly variable. Several diagnostic methods have been developed to assess muscle mass in cancer patients but they are not yet standardized. In addition, there is no specific pharmacological regimen for the treatment of sarcopenia or cachexia at the clinical level.
Conclusion: Nutritional assessment should be a fundamental part of the initial approach to cancer patients and subsequent follow-up. The therapeutic goal is to increase appetite and food intake, attenuate the chronic inflammatory state, and improve exercise capacity and quality.
References
Chow LQM. Head and Neck Cancer. N Engl J Med. 2020 Jan 2;382(1):60-72. doi: 10.1056/NEJMra1715715. DOI: https://doi.org/10.1056/NEJMra1715715
Bressan V, Stevanin S, Bianchi M, Aleo G, Bagnasco A, Sasso L. The effects of swallowing disorders, dysgeusia, oral mucositis and xerostomia on nutritional status, oral intake and weight loss in head and neck cancer patients: A systematic review. Cancer Treat Rev. 2016 Apr;45:105-19. doi: 10.1016/j.ctrv.2016.03.006. Epub 2016 Mar 14. PMID: 27010487. DOI: https://doi.org/10.1016/j.ctrv.2016.03.006
Crowder SL, Douglas KG, Yanina Pepino M, Sarma KP, Arthur AE. Nutrition impact symptoms and associated outcomes in post-chemoradiotherapy head and neck cancer survivors: a systematic review. J Cancer Surviv. 2018 Aug;12(4):479-94. doi: 10.1007/s11764-018-0687-7. Epub 2018 Mar 20. PMID: 29556926. DOI: https://doi.org/10.1007/s11764-018-0687-7
Kubrak C, Martin L, Gramlich L, Scrimger R, Jha N, Debenham B et al. Prevalence and prognostic significance of malnutrition in patients with cancers of the head and neck. Clin Nutr. 2020 Mar;39(3):901-9. doi: 10.1016/j.clnu.2019.03.030. Epub 2019 Apr 4. PMID: 31000341. DOI: https://doi.org/10.1016/j.clnu.2019.03.030
Bossi P, Delrio P, Mascheroni A, Zanetti M. The Spectrum of Malnutrition/Cachexia/Sarcopenia in Oncology According to Different Cancer Types and Settings: A Narrative Review. Nutrients. 2021;13(6):1980. Published 2021 Jun 9. doi:10.3390/nu13061980 DOI: https://doi.org/10.3390/nu13061980
Lyra MMF, Meira JEC, Guedes GDS, Bueno NB. Immunonutrition in head and neck cancer: Systematic review and metanalysis of its clinical and nutritional effects. Clin Nutr ESPEN. 2021 Feb;41:30-41. doi: 10.1016/j.clnesp.2020.12.014. Epub 2021 Jan 11. PMID: 33487281. DOI: https://doi.org/10.1016/j.clnesp.2020.12.014
Morse RT, Ganju RG, Gan GN, Cao Y, Neupane P, Kakarala K et al. Sarcopenia and Treatment Toxicity in Older Adults Undergoing Chemoradiation for Head and Neck Cancer: Identifying Factors to Predict Frailty. Cancers (Basel). 2022 Apr 22;14(9):2094. doi: 10.3390/cancers14092094. PMID: 35565223; PMCID: PMC9103923. DOI: https://doi.org/10.3390/cancers14092094
Hunter M, Kellett J, Toohey K, D’Cunha NM, Isbel S, Naumovski N. Toxicities Caused by Head and Neck Cancer Treatments and Their Influence on the Development of Malnutrition: Review of the Literature. European Journal of Investigation in Health, Psychology and Education. 2020;10(4):935-49. https://doi.org/10.3390/ejihpe10040066 DOI: https://doi.org/10.3390/ejihpe10040066
Lena A, Hadzibegovic S, von Haehling S, Springer J, Coats AJ, Anker MS. Sarcopenia and cachexia in chronic diseases: from mechanisms to treatment. Pol Arch Intern Med. 2021 Dec 22;131(12):16135. doi: 10.20452/pamw.16135. Epub 2021 Nov 15. PMID: 34775741. DOI: https://doi.org/10.20452/pamw.16135
Couch ME, Dittus K, Toth MJ, Willis MS, Guttridge DC, George JR et al. Cancer cachexia update in head and neck cancer: Pathophysiology and treatment. Head Neck. 2015 Jul;37(7):1057-72. doi: 10.1002/hed.23696. Epub 2015 Apr 7. PMID: 24634283. DOI: https://doi.org/10.1002/hed.23696
Couch ME, Dittus K, Toth MJ, Willis MS, Guttridge DC, George JR et al. Cancer cachexia update in head and neck cancer: Definitions and diagnostic features. Head Neck. 2015 Apr;37(4):594-604. doi: 10.1002/hed.23599. Epub 2014 Mar 25. PMID: 24415363. DOI: https://doi.org/10.1002/hed.23599
De Bree R, van Beers MA, Schaeffers AWMA. Sarcopenia and its impact in head and neck cancer treatment. Curr Opin Otolaryngol Head Neck Surg. 2022 Apr 1;30(2):87-93. doi: 10.1097/MOO.0000000000000792. PMID: 35255045. DOI: https://doi.org/10.1097/MOO.0000000000000792
Thureau S, Lebret L, Lequesne J, Cabourg M, Dandoy S, Gouley C et al. Prospective Evaluation of Sarcopenia in Head and Neck Cancer Patients Treated with Radiotherapy or Radiochemotherapy. Cancers (Basel). 2021 Feb 11;13(4):753. doi: 10.3390/cancers13040753. PMID: 33670339; PMCID: PMC7917983. DOI: https://doi.org/10.3390/cancers13040753
Gómez-Pérez AM et al. Recomendaciones del grupo GARIN para el manejo nutricional de pacientes con cáncer de cabeza y cuello. Nutr Clin Med. 2018;XII(1):1-13. doi: 10.7400/NCM.2018.12.1.5058
Álvaro Sanz E, Garrido Siles M, Rey Fernández L, Villatoro Roldán R, Rueda Domínguez A, Abilés J. Nutritional risk and malnutrition rates at diagnosis of cancer in patients treated in outpatient settings: Early intervention protocol. Nutrition. 2019 Jan;57:148-53. doi: 10.1016/j.nut.2018.05.021. Epub 2018 Jun 18. PMID: 30157469. DOI: https://doi.org/10.1016/j.nut.2018.05.021
Przekop Z, Milewska M, Szostak-Węgierek D, Panczyk M, Sobocki J. GLIM-Defined Malnutrition in Patients with Head and Neck Cancer during the Qualification Visit for Home Enteral Nutrition. Nutrients. 2022 Jan 24;14(3):502. doi: 10.3390/nu14030502. PMID: 35276861; PMCID: PMC8840501. DOI: https://doi.org/10.3390/nu14030502
Przekop Z, Szostak-Węgierek D, Milewska M, Panczyk M, Zaczek Z, Sobocki J. Efficacy of the Nutritional Risk Index, Geriatric Nutritional Risk Index, BMI, and GLIM-Defined Malnutrition in Predicting Survival of Patients with Head and Neck Cancer Patients Qualified for Home Enteral Nutrition. Nutrients. 2022 Mar 17;14(6):1268. doi: 10.3390/nu14061268. PMID: 35334925; PMCID: PMC8949001. DOI: https://doi.org/10.3390/nu14061268
Wong A, Zhu D, Kraus D, Tham T. Radiologically Defined Sarcopenia Affects Survival in Head and Neck Cancer: A Meta-Analysis. Laryngoscope. 2021 Feb;131(2):333-41. doi: 10.1002/lary.28616. Epub 2020 Mar 27. PMID: 32220072. DOI: https://doi.org/10.1002/lary.28616
Vangelov B, Bauer J, Moses D, Smee R. A prediction model for skeletal muscle evaluation and computed tomography-defined sarcopenia diagnosis in a predominantly overweight cohort of patients with head and neck cancer. Eur Arch Otorhinolaryngol. 2022 Jul 14. doi: 10.1007/s00405-022-07545-x. Epub ahead of print. PMID: 35835910. DOI: https://doi.org/10.1007/s00405-022-07545-x
Ticinesi A, Meschi T, Narici MV, Lauretani F, Maggio M. Muscle Ultrasound and Sarcopenia in Older Individuals: A Clinical Perspective. J Am Med Dir Assoc. 2017 Apr 1;18(4):290-300. doi: 10.1016/j.jamda.2016.11.013. Epub 2017 Feb 13. PMID: 28202349. DOI: https://doi.org/10.1016/j.jamda.2016.11.013
Mirón Mombiela R, Vucetic J, Rossi F, Tagliafico AS. Ultrasound Biomarkers for Sarcopenia: What Can We Tell So Far? Semin Musculoskelet Radiol. 2020 Apr;24(2):181-193. doi: 10.1055/s-0039-3402745. Epub 2020 May 21. PMID: 32438444. DOI: https://doi.org/10.1055/s-0039-3402745
Capozzi LC, Boldt KR, Lau H, Shirt L, Bultz B, Culos-Reed SN. A clinic-supported group exercise program for head and neck cancer survivors: managing cancer and treatment side effects to improve quality of life. Support Care Cancer. 2015 Apr;23(4):1001-7. doi: 10.1007/s00520-014-2436-4. Epub 2014 Sep 27. PMID: 25256377. DOI: https://doi.org/10.1007/s00520-014-2436-4
Silva PB, Ramos GHA, Petterle RR, Borba VZC. Sarcopenia as an early complication of patients with head and neck cancer with dysphagia. Eur J Cancer Care (Engl). 2021 Jan;30(1):e13343. doi: 10.1111/ecc.13343. Epub 2020 Oct 12. PMID: 33043532. DOI: https://doi.org/10.1111/ecc.13343
Llames L, Baldomero V, Iglesias ML, Rodota LP. Valores del ángulo de fase por bioimpedancia eléctrica; estado nutricional y valor pronóstico [Values of the phase angle by bioelectrical impedance; nutritional status and prognostic value]. Nutr Hosp. 2013 Mar-Apr;28(2):286-95. Spanish. doi: 10.3305/nh.2013.28.2.6306. PMID: 23822677.
Selberg O, Selberg D. Norms and correlates of bioimpedance phase angle in healthy human subjects, hospitalized patients, and patients with liver cirrhosis. Eur J Appl Physiol 2002; 86 (6): 509-16. Epub 2002 Jan 31. PubMed PMID: 11944099. DOI: https://doi.org/10.1007/s00421-001-0570-4
Gupta D, Lammersfeld CA, Vashi PG, King J, Dahlk SL, Grutsch JF et al. Bioelectrical impedance phase angle as a prognostic indicator in breast cancer. BMC Cancer 2008; 8: 249. PubMed PMID: 18727837; PubMed Central PMCID: PMC2527613. DOI: https://doi.org/10.1186/1471-2407-8-249
Grossberg AJ, Rock CD, Edwards J, Mohamed ASR, Ruzensky D, Currie A et al. Bioelectrical impedance analysis as a quantitative measure of sarcopenia in head and neck cancer patients treated with radiotherapy. Radiother Oncol. 2021 Jun;159:21-7. doi: 10.1016/j.radonc.2021.03.005. Epub 2021 Mar 15. PMID: 33736997; PMCID: PMC8205950. DOI: https://doi.org/10.1016/j.radonc.2021.03.005
Cruz-Jentoft AJ, Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019 Jul 1;48(4):601. doi: 10.1093/ageing/afz046. Erratum for: Age Ageing. 2019 Jan 1;48(1):16-31. PMID: 31081853; PMCID: PMC6593317.
39. Bertazzoni G, Testa G, Tomasoni M, Mattavelli D, Del Bon F, Montalto N et al. The Enhanced Recovery After Surgery (ERAS) protocol in head and neck cancer: a matched-pair analysis. Acta Otorhinolaryngol Ital. 2022 Aug;42(4):325-33. doi: 10.14639/0392-100X-N2072. PMID: 36254650; PMCID: PMC9577693. DOI: https://doi.org/10.14639/0392-100X-N2072
Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H, Bozzetti F et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr. 2017 Feb;36(1):11-48. doi: 10.1016/j.clnu.2016.07.015. Epub 2016 Aug 6. PMID: 27637832. DOI: https://doi.org/10.1016/j.clnu.2016.07.015
Talwar B, Donnelly R, Skelly R, Donaldson M. Nutritional management in head and neck cancer: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol. 2016;130(S2):S32-S40. doi:10.1017/S0022215116000402 DOI: https://doi.org/10.1017/S0022215116000402
Bossola M. Nutritional interventions in head and neck cancer patients undergoing chemoradiotherapy: a narrative review. Nutrients. 2015 Jan 5;7(1):265-76. doi: 10.3390/nu7010265. PMID: 25569622; PMCID: PMC4303838. DOI: https://doi.org/10.3390/nu7010265
Weber MG, Dias SS, de Angelis TR, Fernandes EV, Bernardes AG, Milanez VF et al. The use of BCAA to decrease delayed-onset muscle soreness after a single bout of exercise: a systematic review and meta-analysis. Amino Acids. 2021 Nov;53(11):1663-1678. doi: 10.1007/s00726-021-03089-2. Epub 2021 Oct 20. PMID: 34669012. DOI: https://doi.org/10.1007/s00726-021-03089-2
Kamei Y, Hatazawa Y, Uchitomi R, Yoshimura R, Miura S. Regulation of Skeletal Muscle Function by Amino Acids. Nutrients. 2020 Jan 19;12(1):261. doi: 10.3390/nu12010261. PMID: 31963899; PMCID: PMC7019684. DOI: https://doi.org/10.3390/nu12010261
Barazzoni R, Deutz N, Biolo G, Bischoff S, Boire Y, Cederholm T et al. Carbohydrates and insulin resistance in clinical nutrition: recommendations from the ESPEN expert group. Clin Nutr. 2017;36:355-63. DOI: https://doi.org/10.1016/j.clnu.2016.09.010
Muscaritoli M, Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H et al. ESPEN practical guideline: Clinical Nutrition in cancer. Clin Nutr. 2021 May;40(5):2898-913. doi: 10.1016/j.clnu.2021.02.005. Epub 2021 Mar 15. PMID: 33946039. DOI: https://doi.org/10.1016/j.clnu.2021.02.005
Cornejo-Pareja I, Ramirez M, Camprubi-Robles M, Rueda R, Vegas-Aguilar IM, Garcia-Almeida JM. Effect on an Oral Nutritional Supplement with β-Hydroxy-β-methylbutyrate and Vitamin D on Morphofunctional Aspects, Body Composition, and Phase Angle in Malnourished Patients. Nutrients. 2021 Dec 3;13(12):4355. doi: 10.3390/nu13124355. PMID: 34959907; PMCID: PMC8706927. DOI: https://doi.org/10.3390/nu13124355
Midgley AW, Lowe D, Levy AR, Mepani V, Rogers SN. Exercise program design considerations for head and neck cancer survivors. Eur Arch Otorhinolaryngol. 2018 Jan;275(1):169-79. doi: 10.1007/s00405-017-4760-z. Epub 2017 Oct 20. PMID: 29058083; PMCID: PMC5754417. DOI: https://doi.org/10.1007/s00405-017-4760-z
Crowder SL, Douglas KG, Frugé AD, Carroll WR, Spencer SA, Locher JL et al. Head and neck cancer survivors' preferences for and evaluations of a post-treatment dietary intervention. Nutr J. 2019 Sep 10;18(1):57. doi: 10.1186/s12937-019-0479-6. PMID: 31506077; PMCID: PMC6737706. DOI: https://doi.org/10.1186/s12937-019-0479-6
Aghili M, Farhan F, Rade M. A pilot study of the effects of programmed aerobic exercise on the severity of fatigue in cancer patients during external radiotherapy. Eur J Oncol Nurs. 2007 Apr;11(2):179-82. doi: 10.1016/j.ejon.2006.03.005. Epub 2007 Mar 13. PMID: 17360236. DOI: https://doi.org/10.1016/j.ejon.2006.03.005
Downloads
Published
License
Copyright (c) 2024 Nutrición Clínica y Dietética Hospitalaria
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Los lectores pueden utilizar los textos publicados de acuerdo con la definición BOAI (Budapest Open Access Initiative)
