Refeeding Syndrome in Head and Neck Cancer: Diagnostic and Indigenous Diet-Based Protocols for Survival and Nutritional Assessment in a Single-Centre Prospective Study in Assam, India

Abstract Introduction: Refeeding Syndrome (RFS) is a potentially fatal metabolic disorder that can occur after prolonged periods of starvation in severely malnourished patients. In head and neck cancer (HNC) patients undergoing radio(chemo)therapy, RFS can be a hidden cause of mortality. Methods: In a single-centre study, the prevalence of HNC patients at high risk of developing RFS was detected as per the National Institute for Health and Care Excellence (NICE) criteria. Further, the effect of an omega-3 fatty-acid-enriched diet plan was assessed amongst patients in two groups: control (n = 43 participants; 58.8 ± 11.6 years, 70% male) and diet treatment (n = 47 participants; 57.7 ± 12.02 years, 66% male). Results: The incidence of high RFS risk in HNC patients was 41.5%. All diagnosed patients were supplemented with electrolytes for two weeks, leading to a 100% survival rate until one month. The omega-3 fatty-acid-enriched diet plan was found to stabilize the net body weight and body mass index in a week and showed a minimal net positive increase in a month, compared to the iso-calorific and iso-nitrogenous diet of the control group. Conclusions: This pilot study highlights the importance of developing diagnostic and indigenous diet-based protocols for HNC patients at risk of RFS. To the best of our knowledge, this is the first study on RFS in HNC patients in India and South Asia.