Patients with head and neck cancer are one of the populations with high incidence of malnutrition. The nutritional support methods include oral feeding, enteral nutrition and parenteral nutrition. Refeeding syndrome, as a nutrition-related metabolic disease, often occurs in patients with head and neck cancer (HNC)when they re-feed. This article reviews the nutritional management of patients with head and neck cancer, the identification and prevention of refeeding syndrome in patients with head and neck cancer, in order to provide scientific basis for clinical staff to effectively identify and prevent refeeding syndrome.

Tang Yipin, Li Jieqiong, Liu Xuanxuan, Zhang Mi, Gao Ya, You Ning. Research progress in the recognition and prevention of refeeding syndrome in patients with head and neck cancer. Academic Journal of Medicine & Health Sciences (2022) Vol. 3, Issue 3: 1-6. https://doi.org/10.25236/AJMHS.2022.030301.

[1] Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018 Nov;68(6):394-424. 

[2] Chen RY, Lin YC, Shen WC, Hsieh TC, Yen KY, Chen SW, Kao CH. Associations of Tumor PD-1 Ligands, Immunohistochemical Studies, and Textural Features in 18F-FDG PET in Squamous Cell Carcinoma of the Head and Neck. Sci Rep. 2018 Jan 8; 8(1):105.

[3] Ehrsson YT, Langius-Eklöf A, Laurell G. Nutritional surveillance and weight loss in head and neck cancer patients. Support Care Cancer. 2012; 20(4):757-765. 

[4] Langius JA, Doornaert P, Spreeuwenberg MD, Langendijk JA, Leemans CR, van Bokhorst-de van der Schueren MA. Radiotherapy on the neck nodes predicts severe weight loss in patients with early stage laryngeal cancer. Radiother Oncol. 2010; 97(1):80-85. 

[5] Müller-Richter U, Betz C, Hartmann S, Brands RC. Nutrition management for head and neck cancer patients improves clinical outcome and survival. Nutr Res. 2017 Dec;48:1-8. 

[6] Ackerman D, Laszlo M, Provisor A, Yu A. Nutrition Management for the Head and Neck Cancer Patient. Cancer Treat Res. 2018; 174:187-208. 

[7] Vangelov B, Venchiarutti RL, Smee RI. Critical Weight Loss in Patients With Oropharynx Cancer During Radiotherapy (±Chemotherapy).Nutr Cancer.2017;69(8):1211-1218. 

[8] Kondrup J, Allison SP, Elia M, Vellas B, Plauth M; Educational and Clinical Practice Committee, European Society of Parenteral and Enteral Nutrition (ESPEN). ESPEN guidelines for nutrition screening 2002. Clin Nutr. 2003;22(4):415-421. 

[9] Yu Kang, Sun Wenyan. The role of nursing staff in nutritional risk screening [J]. China Nursing Management,2020,20(3):324-327.

[10] Lu L, Gu M J. Effect of nutritional risk on quality of life and postoperative complications in patients with laryngeal cancer [J]. Chinese Journal of Gerontology,2015(24):7142-7144.

[11] Pfister DG, Spencer S, Adelstein D, et al. Head and Neck Cancers, Version 2.2020, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2020;18(7):873-898. 

[12] Edwards A, Baldwin N, Findlay M, Brown T, Bauer J. Evaluation of the agreement, adoption, and adherence to the evidence-based guidelines for the nutritional management of adult patients with head and neck cancer among Australian dietitians. Nutr Diet. 2022;79(2):197-205. 

[13] Cancer Radiotherapy Nutrition Group, Cancer Nutrition and Support Committee, Chinese Anti-Cancer Association. [J]. Chin J Radiation Oncology,2018,27(1):1-6.

[14] Chinese Society of Parenteral and Enteral Nutrition. Nutritional support guidelines for cancer patients [J]. Chin J Surg,2017,55(11):801-829.

[15] Nutrition screening and nutrition assessment. Chinese Journal of Medical Information, 2022, 37(07):16-16.

[16] Tu Yi, Wu Wanying, Liang Biao, et al. Comparison of NRS 2002 and PG-SGA in perioperative nutritional assessment of patients with head and neck squamous cell carcinoma [J]. Chin J Modern Nursing,2019,25(25):3219-3222.

[17] Wang Xuan, Qin Nan, Jiang Guichun. Relationship between nutritional status and quality of life in patients with head and neck radiation oral mucositis [J]. Journal of Cancer Metabolism and Nutrition Electronic,2020,7(1):52-56.

[18] Jiang Chengfang,Xi Shuxin,Shen Lina,et al. Evidence-based practice of nutritional management in patients undergoing inpatient surgery for head and neck cancer[J]. Journal of Advanced Nurse Practitioner Training,2020,35(22):2028-2033. 

[19] Thompson KL, Elliott L, Fuchs-Tarlovsky V, Levin RM, Voss AC, Piemonte T. Oncology Evidence-Based Nutrition Practice Guideline for Adults. J Acad Nutr Diet. 2017; 117(2):297-310.e47. 

[20] Wang YL, Hu Y, Xie ZF, et al. Summary of the best evidence on nutritional management of patients undergoing radiotherapy for head and neck cancer[J]. Journal of Liberation Army Nursing, 2022,39(1):63-67. 

[21] Talwar B, Donnelly R, Skelly R, Donaldson M. Nutritional management in head and neck cancer: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol. 2016;130(S2): S32-S40. 

[22] Lin MC, Shueng PW, Chang WK, et al. Consensus and clinical recommendations for nutritional intervention for head and neck cancer patients undergoing chemoradiotherapy in Taiwan. Oral Oncol. 2018;81:16-21. 

[23] Bateman RM, Sharpe MD, Jagger JE, et al. 36th International Symposium on Intensive Care and Emergency Medicine : Brussels, Belgium. 15-18 March 2016 [published correction appears in Crit Care. 2016 Oct 24;20:347]. Crit Care. 2016;20(Suppl 2):94. Published 2016 Apr 20. 

[24] Rasmussen SO, Kristensen MB, Wessel I, Andersen JR. Incidence and Risk Factors of Refeeding Syndrome in Head and Neck Cancer Patients-An Observational Study. Nutr Cancer. 2016;68(8): 1320-1329. 

[25] Wang Qingyuan,Xie Tuxiu,Wei Jie,et al. Research progress of refeeding syndrome in critical illness[J]. China Medicine Herald,2022,19(12):30-33,60. 

[26] Long X X,Yao M Q,Yao J L. Clinical characteristics and nursing progress of ICU refeeding syndrome[J]. Nursing Research,2020,34(23):4231-4235.

[27] Wei M,Wu YF. Research progress of refeeding syndrome[J]. Parenteral and enteral nutrition, 2020,27(04):243-247.

[28] Boot R, Koekkoek KWAC, van Zanten ARH. Refeeding syndrome: relevance for the critically ill patient. Curr Opin Crit Care. 2018;24(4):235-240.  

[29] Nguyen, P et al. “Refeeding-Syndrom : Pathophysiologie, Therapie und welche rheumatologischen Patienten besonders gefährdet sind” [Refeeding syndrome : Pathophysiology, treatment and which rheumatic patients are particularly at risk]. Zeitschrift fur Rheumatologie vol. 80,3 (2021): 263-269. 

[30] da Silva JSV, Seres DS, Sabino K, et al. ASPEN Consensus Recommendations for Refeeding Syndrome [published correction appears in Nutr Clin Pract. 2020 Jun;35(3):584-585]. Nutr Clin Pract. 2020; 35(2):178-195. 

[31] Szeja N, Grosicki S. Refeeding syndrome in hematological cancer patients - current approach. Expert Rev Hematol. 2020;13(3):201-212. 

[32] Wu M, Lian XJ, Sun P. The role of nutritional support for the prevention of refeeding syndrome in patients with mining accidents[J]. Parenteral and enteral nutrition, 2019,26(02):87-90.

[33] Friedli N, Stanga Z, Culkin A, et al. Management and prevention of refeeding syndrome in medical inpatients: An evidence-based and consensus-supported algorithm. Nutrition. 2018;47:13-20. 

[34] Nutrition support for adults: oral nutrition support, enteral tube feeding and parenteral nutrition. London: National Institute for Health and Care Excellence (NICE); August 2017.

[35] Matthews KL, Capra SM, Palmer MA. Throw caution to the wind: is refeeding syndrome really a cause of death in acute care?. Eur J Clin Nutr. 2018;72(1):93-98. 

[36] Nunes, Gonçalo et al. “Refeeding syndrome in the gastroenterology practice: how concerned should we be?.” European journal of gastroenterology & hepatology vol. 30,11 (2018): 1270-1276. 

[37] Long Xingxia, Yao Meiqi,Yao Jinlan,Wang Haiyan.Study on the current situation and factors influencing the occurrence of refeeding syndrome in patients with enteral nutrition in ICU[J]. Chinese Journal of Nursing, 2021,56(06):818-823.

[38] Mi Y.Y., Huang P.P., Dong J., et al. Summary of the best evidence for the prevention and management of enteral nutrition intolerance in critically ill patients [J]. Chinese Journal of Nursing, 2019, 54(12): 1868-1876.