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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Head and Neck Cancer
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1433503
This article is part of the Research Topic Advanced Head and Neck Cancer: from Organ Preservation Strategies to extended resections and reconstruction View all 5 articles

Patient-Reported Quality of Life and Adherence Outcomes after Integrating Exclusive Liquid Meal Replacement in Patients with Head and Neck Cancer Undergoing Chemoradiation: Results from a Phase II Study

Provisionally accepted
Luca Faustino Valle Luca Faustino Valle Fang-I Chu Fang-I Chu Xiaoyan Wang Xiaoyan Wang Andrew Erman Andrew Erman Jackie Hernandez Jackie Hernandez Elizabeth Kaoh Elizabeth Kaoh Nicolas Edgar Nicolas Edgar Ann Raldow Ann Raldow DEBORAH WONG DEBORAH WONG Michael Lee Steinberg Michael Lee Steinberg Amar U. Kishan Amar U. Kishan Robert K Chin Robert K Chin John Hegde John Hegde *
  • University of California, Los Angeles, Los Angeles, United States

The final, formatted version of the article will be published soon.

    Objectives: Preventing malnutrition during chemoradiation (CRT) for head and neck cancer is critical maximizing quality of life (QOL). We sought to assess patient-reported QOL outcomes after integrating exclusive liquid meal replacement with Soylent, a novel meal replacement agent, in patients with head and neck cancer undergoing CRT.: Patients undergoing definitive or adjuvant concurrent CRT for locally advanced head and neck cancer enrolled on our single-institution, prospective phase II protocol evaluating nutritional replacement with Soylent. Patients who reached 5% body weight loss during CRT were transitioned to Soylent meal replacement for all nutritional needs. Patients who reached 10% body weight loss were recommended for gastrostomy tube (G-tube) placement. UW-QOL and FACT-H&N questionnaires assessed patient-reported QOL prior to the receipt of CRT and following conclusion of CRT. Paired t-test or Wilcoxon signed-rank test were performed to assess for differences between scores at each follow-up time point and baseline.Results: Of the 60 enrolled patients, 51/60 (85%) lost 5% of their pre-treatment body weight. Among these patients, 48/51 (94%) were successfully transitioned to Soylent. 22/48 patients subsequently lost 10% of their pre-treatment body weight, and 3/22 (14%) underwent G-tube placement with the remainder declining. This resulted in an overall G-tube rate of 5%. Among the 41 patients evaluable for QOL data, the nadirs for overall and health-related UW-QOL were reached at 1 month and rebounded to exceed baseline by 6 months. FACT-H&N survey scores were reduced from 32 at baseline to 20 at 1 month (adjusted p<0.001) and 26 at 3 months (adjusted p<0.001), but increased to 29, 30, and 27 at 6, 12, and 18 months, without significant differences as compared to baseline (adjusted p>0.38 for all).We report high patient adherence and a 5% G-tube placement rate with exclusive meal replacement with Soylent in patients undergoing concurrent CRT for head and neck cancers.

    Keywords: head and neck cancer, chemoradiation (CRT), nutrition, gastrostomy tube, Quality of Life

    Received: 16 May 2024; Accepted: 25 Nov 2024.

    Copyright: © 2024 Valle, Chu, Wang, Erman, Hernandez, Kaoh, Edgar, Raldow, WONG, Steinberg, Kishan, Chin and Hegde. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: John Hegde, University of California, Los Angeles, Los Angeles, United States

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.