Inclusion Criteria:  age of 18-65 years histological confirmation of stage II-IVb non-metastatic HNC according to the seventh edition of the American Joint Committee on Cancer Staging System (AJCC 2010) receipt of definitive CCRT Eastern Cooperative Oncology Group performance status of 0-1 creatinine clearance ≥ 60 mL/min/1.73 m2 calculated by the Cockcroft-Gault formula absence of mucositis able to tolerate oral feeding  Exclusion Criteria:  receipt of curative surgery for HNC allergies to any component of the immunonutrition