Normalcy of food intake in head and neck cancer patients receiving radiotherapy supported by swallowing therapy and individual dietary councelling.

Oral nutrition appears to be a challenge for patients with head and neck cancer
(HNC patients) after radiotherapy. Many patients desire to their usual food
intake and to return to oral nutrition with normal consistency (without
modifications) but due to the swallowing problems experienced post treatment
this seems tremendously difficult. Referral to a speech therapist is not a
standard procedure in the RUNMC as part of pre-, -per and post-treatment
radiotherapy. Swallowing intervention might support nutritional intervention
and in that way improve quantity and quality of food intake, reduce the need
for tube feeding.

To improve normalcy of food intake (food quantity and quality, decrease use of
tube feeding/ nutritional supplements) in patients with head and neck cancer
with pre-, per- and post treatment radiotherapy due to individually tailored
swallowing therapy by an experienced speech-language therapist in cooperation
Individual dietary councelling by an experienced dietician.

Secondary objectives are:
-patients quality of life
-nutritional status.

A prospective, randomized study will be carried out at the department of
Radiotherapy, Rehabilitation and Gastroenterology - dietetics, RUNMC. One group
will receive individualized swallowing therapy by a speech-language therapist
(SLT), pre-, per- and post treatment in cooperation with extensive dietary
councelling by a specialized dietician. The other group will have standard
usual care for head and neck cancer patient treated with radiotherapy including
extensive dietary councelling by a specialized dietician.

The experimental group will be monitored and treated (when needed) by an
experienced SLT to compensate for any consequence of the tumor or adverse event
of the radiotherapy on the efficiency or safety of oropharyngeal swallowing, as
is recommended by the Dutch guidelines. The monitoring and interventions will
start as soon as the radiotherapy has been decided and planned, until 6 months
after the last radiotherapy session. To further optimize the efficacy and
efficiency of the rehabilitation the SLT cooperates closely with an experienced
dietician by protocol, to ensure that every patient receives the most suitable
nutritional advice at every moment from pre-radiotherapy until 6 month after
radiotherapy.

Not applicable