The Relationship Between Intake of Macro and Micronutrients With Clinical Outcomes of Head and Neck Cancer Patients

Study Overview
=================
Brief Summary
-----------------
Cancer is a disease caused by uncontrolled cells growth, and its incidence is increasing worldwide. One of the most common cancer is head and neck cancer (HNC), which has low survival rate. Malnutrition occurrence in HNC lower immune system and as result, decreased survival rate was found. Risk factors including tumor histopathology, nutritional status, immune system, and environment have various effects on life expectancy. Head and neck cancer treatments such as radiotherapy, chemotherapy, and surgery are not without complications. Xerostomia, stomatitis, anorexia, nausea and vomiting, dysgeusia, ageusia, also pain are commonly found during the HNC treatment procedure, and takes part in further undernutrition findings in HNC patients. Adequate nutrition management has favorable impact in managing HNC patients' malnutrition related problems. Not only energy intake, but also macronutrients and micronutrients intake have been proved be beneficial in the outcomes of HNC patients. Branched-chain amino acids (BCAA) and zinc are namely two nutrients that have been hypothesized to be beneficent. Branched-chain amino acids are found to increase muscle mass, amino acid pools, and immune system, which resulted in preventing malnutrition and cachexia, also increasing total lymphocyte count in cancer patients. Zinc plays role in immune system, antioxidant process, and taste bud functions. Zinc supplementation is correlated to give a better outcome in taste perception and stomatitis in HNC patients who undergo radiotherapy. This study aims to finds the correlation between BCAA intake with muscle mass and lymphocyte count in HNC patients who haven't undergone chemoradiotherapy, zinc correlation with gustatory in HNC patients who haven't undergone chemoradiotherapy, zinc correlation with stomatitis in HNC patients who is having radiotherapy treatment, and energy and protein intake with body weight in HNC patients after underwent radiotherapy.

Official Title
-----------------
The Relationship Between Intake of Macro and Micronutrients With Clinical Outcomes of Head and Neck Cancer Patients at the Radiotherapy Unit of Dr. Cipto Mangunkusumo Hospital

Conditions
-----------------
Head and Neck Cancer

Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: head and neck cancer patients who haven't undergone radiotherapy or chemotherapy, during radiotherapy, and after radiotherapy Exclusion Criteria: have contraindications for body composition measuring are immunodeficient or have autoimmune disease during immunosuppressant drugs treatment

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------
What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| body weight | body weight in kilogram | after radiotherapy (1 day) | 
| total lymphocyte count | TLC in 1000/mcL | before radiotherapy (1 day) | 
| taste bud perception | Henkin test | before radiotherapy (1 day) | 
| stomatitis | stomatitis grade using WHO criteria | during radiotherapy (1 day) | 
| muscle mass | body composition analyzer, result in kg. | before radiotherapy (1 day) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| protein intake | protein intake using food frequency questionnaire and 24-hrs food recall, data calculated using nutrisurvey | during the first meeting (1 day) | 
| energy intake | energy intake using food frequency questionnaire and 24-hrs food recall, data calculated using nutrisurvey | during the first meeting (1 day) | 
| BCAA intake | BCAA intake using food frequency questionnaire and 24-hrs food recall, data calculated using nutrisurvey | during the first meeting (1 day) | 
| zinc intake | zinc intake using food frequency questionnaire and 24-hrs food recall, data calculated using nutrisurvey | during the first meeting (1 day) | 
| hair zinc level | zinc level in hair | during the first meeting if the patients undergo radiotherapy (1 day) |