Proactive versus Reactive Nutrition Therapy in Head and Neck Cancer Patients Treated with Chemoradiotherapy: A Case Series

Introduction: Malnutrition is frequently found in head and neck cancer (HNC) patients subjected to chemoradiotherapy. Furthermore, the condition can hinder therapy and increase patient mortality. Nutrition therapy may be given proactively and reactively before and during chemoradiotherapy, as a response to nutritional status deterioration. Early or proactive nutrition therapy is considered superior in minimizing weight loss and interruption days during chemoradiotherapy. Therefore, this study aims to explore the clinical impact of proactive and reactive nutrition therapies.Case Presentation: A total of 4 HNC patients were subjected to chemoradiotherapy and received nutrition therapy at different points. Approximately 2 patients received proactive nutrition therapy, while the other 2 underwent reactive nutrition after cancer treatment. Increased intake was achieved through administering oral nutrition supplements and supporting a nasogastric tube. Patients who received proactive nutrition therapy experienced less weight loss compared to reactive therapy. Delayed initiation of nutrition therapy resulted in a more pronounced weight loss. Therefore, it was crucial to maintain energy intake in line with established recommendations to effectively uphold the nutritional status of cancer patients.Conclusions: Proactive nutrition therapy should be provided to HNC patients before the commencement of cancer therapy.