Increasing dietary supervision can reduce weight loss in oral cancer patients

Weight loss after treatment for intraoral malignancy is common and can impair patient recovery and wound healing. We report a reduction in weight loss in patients undergoing combined-modality treatment (surgery + radiotherapy) after an increase in dietary supervision and changes to the patient dietary protocol. Two groups of patients were compared: Group I received treatment before the protocol changes, and Group II received treatment after the changes took effect. After surgery the average weight loss for Group I was 3.67% compared with 2.42% for Group II (P < 0.05), after radiotherapy the average weight loss for Group I was 6.56% compared with 4.83% for Group II (P < 0.05), and after combined-modality treatment the average weight loss for Group I was 9.83% compared with 6.6% for Group II (P < 0.05). The successful protocol changes included increased supervision of patients by the dedicated head-and-neck team dietitian when patients were undergoing radiotherapy, including the period between completion of surgery and commencement of radiotherapy. The period of time spent without specialist dietary supervision was therefore reduced. Specific guidelines were devised to allow for increased dietary input when required, specifically, if patients lost weight for > or = 2 wk or if they were being fed enterally. These changes were made after an audit that demonstrated that severe weight loss in this group of patients was common. We have demonstrated that regular appraisal of weight loss in this group of patients is valuable and that this weight loss can be reduced if appropriate action is taken.