Guidelines for nutrition in adults with head and neck cancer: The American Society for Parenteral and Enteral Nutrition

IF 3.3 3区医学 Q2 NUTRITION & DIETETICS

Journal of Parenteral and Enteral Nutrition Pub Date : 2026-04-02 Epub Date: 2026-03-03 DOI:10.1002/jpen.70067

Nicole Kiss PhD, Merran Findlay PhD, Jacqui Frowen PhD, SP, Whitney E. Lewis PharmD, Jeannine Mills MS, RDN, Anurag K. Singh MD, David D. Church PhD, Jacob T. Mey PhD, RD, Sarah Peterson PhD, RD, Kathleen Aguzzi RD, Sarah Bellini PhD, RDN, Maria Paula Villela Coelho MD, Laura Cordwin MMN, RDN, Michael Duffy MS, RD, Shanna Hager PharmD, Manpreet S. Mundi MD, Michael Owen-Michaane MD, Kathleen Price PhD, RDN, Heather Stanner MS, RD, Bridget Storm MA, Malika Udagedara MD, MSc, Liam McKeever PhD, RDN

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引用次数: 0

Abstract

Background

Head and neck cancer represents the seventh most common cancer diagnosis globally. Maintaining sufficient nutrition is important for preventing malnutrition (undernutrition) and muscle wasting, which contribute to worse outcomes, although many patients are unable to maintain adequate oral intake throughout treatment. This guideline provides practice guidance on nutrition care for patients with head and neck cancer.

Methods

An interdisciplinary team developed key questions and scanned results from a systematic search of the PubMed, EMBASE, CINAHL, and Cochrane Central databases back to 2001. Recommendations were created for key questions concerning timing and duration of nutrition support (early vs delayed enteral nutrition [EN], postoperative feeding, and perioperative dietitian intervention), frequency of dietitian and speech pathology consultations, nutrition screening and assessment, macronutrient requirements, enteral access devices, adjunctive strategies (appetite stimulants and continuation of oral intake alongside EN), specialized nutrients (arginine, glutamine, ω-3, and immunonutrition), and interdisciplinary care.

Results

Ninety-two studies were included. Recommendations were made supporting early initiation of EN when oral intake is inadequate, nutrition within 24 h after surgery, weekly consultation with a dietitian during radiotherapy, malnutrition screening and assessment with validated tools, interdisciplinary models of care, dietitian involvement before and after surgery, and when to consider use of specialized nutrients. Recommendations are also provided for protein intake (1.2–1.5 g/kg/day) and energy intake (≥30 kcal/kg/day).

Conclusion

This guideline provides guidance for the nutrition care of patients with head and neck cancer, identifies research gaps, and calls for standardized outcome reporting to further the state of the evidence. This paper was approved by the ASPEN Board of Directors.

Abstract Image

查看原文本刊更多论文

成人头颈癌患者营养指南：美国肠外和肠内营养学会。

背景：头颈癌是全球第七大常见癌症诊断。尽管许多患者在整个治疗过程中无法维持足够的口服摄入量，但保持足够的营养对于预防营养不良（营养不足）和肌肉萎缩非常重要，这两种情况会导致更糟糕的结果。本指南为头颈癌患者的营养护理提供了实践指导。方法：一个跨学科团队从PubMed、EMBASE、CINAHL和Cochrane Central数据库系统检索2001年以来的关键问题和扫描结果。针对以下关键问题提出了建议：营养支持的时机和持续时间（早期与延迟肠内营养[EN]、术后喂养和围手术期营养师干预）、营养师和语言病理学咨询的频率、营养筛查和评估、大量营养素需求、肠内准入设备、辅助策略（食欲刺激剂和继续口服EN）、特殊营养素（精氨酸、谷氨酰胺、ω-3、ω-3、ω-3）。免疫营养)和跨学科护理。结果：纳入92项研究。建议支持在口服摄入不足时尽早开始EN，在手术后24小时内进行营养，在放射治疗期间每周咨询营养师，使用有效的工具进行营养不良筛查和评估，跨学科的护理模式，术前和术后营养师的参与，以及何时考虑使用专门的营养素。建议蛋白质摄入量（1.2-1.5 g/kg/day）和能量摄入量（≥30 kcal/kg/day）。结论：本指南为头颈癌患者的营养护理提供了指导，确定了研究空白，并呼吁标准化的结果报告以进一步完善证据状态。本论文经ASPEN董事会批准。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Parenteral and Enteral Nutrition 医学-营养学

CiteScore

7.80

自引率

8.80%

发文量

161

审稿时长

6-12 weeks

期刊介绍： The Journal of Parenteral and Enteral Nutrition (JPEN) is the premier scientific journal of nutrition and metabolic support. It publishes original peer-reviewed studies that define the cutting edge of basic and clinical research in the field. It explores the science of optimizing the care of patients receiving enteral or IV therapies. Also included: reviews, techniques, brief reports, case reports, and abstracts.