Resistance Training, Nutritional Interventions Prevent Muscle Loss During, After Radiotherapy for Head and Neck Cancer

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Intervention with resistance training following RT may help prevent many common adverse events.
Intervention with resistance training following RT may help prevent many common adverse events.

Intervention with resistance training and nutritional supplements during and after radiotherapy is not only feasible, but may also prevent muscle mass loss and improve quality of life in patients with head and neck cancer (HNC), according to a study published in Cancer.

Radiotherapy is a standard treatment for patients with HNC, but patients who undergo treatment experience many adverse events (AEs). AEs such as mucositis and dry mouth can eventually lead to swallowing dysfunction, decreased food intake, malnutrition, and muscle loss. 

This trial randomly assigned 41 patients with HNC to receive an exercise and nutrition intervention during radiotherapy (EN-DUR) or after (EN-AF).  Patients assigned to EN-DUR initiated treatment in the first week of radiotherapy and continued for 6 weeks. Patients in the EN-AF group initiated a 3-week intervention 2 to 4 weeks after radiotherapy. The intervention consisted of progressive resistance training (PRT) and oral nutritional supplementation (ONS).

Of the patients who initiated EN-DUR, 90% (18 of 20) of patients completed the intervention. Adherence to PRT was 81% and 57% for ONS. Of the patients who initiated EN-AF, 52% (11 of 21) of patients completed the intervention. Adherence to PRT was 94% and 76% for ONS.

Both interventions were effective in preventing the loss of muscle mass during radiotherapy, and there was no demonstrable difference in muscle mass between the 2 groups from baseline to week 14.

The results show that PRT and ONS are feasible and effective interventions for patients with HNC receiving radiotherapy. The investigators conclude that “interventions both during and after RT appear to mitigate muscle wasting compared with standard care, calling for future trials to assess the feasibility and effects of extended interventions conducted throughout the treatment trajectory.”

Reference

1. Sandmael JA, Bye A, Solheim TS, et al. Feasibility and preliminary effects of resistance training and nutritional supplements during versus after radiotherapy in patients with head and neck cancer: a pilot randomized trial [published online July 31, 2017]. Cancer. doi: 10.1200/cncr.20901

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