Feasibility and preliminary effects of combined exercise and nutritional intervention on muscle mass preservation during chemoradiotherapy for head and neck cancer: a prospective study.

PURPOSE: To evaluate the impact of combined exercise and nutritional intervention including branched-chain amino acids on the prevention of muscle mass decline and related physical dysfunction during concurrent chemoradiotherapy (CCRT) in patients with head and neck cancer (HNC).

METHODS

This prospective, single-center study included 29 patients with HNC undergoing definitive cisplatin-based CCRT. Exercise intervention comprised resistance and endurance training, 30 min per day, 5 days per week. Nutritional intervention involved a daily liquid oral supplement (250 mL) providing 320 kcal and 4,600 mg of leucine, in addition to regular meals. Adherence to each intervention was recorded; patients were classified into higher (HA) and lower adherence (LA) groups based on the median overall adherence rate. Changes in body composition, muscle strength, and physical function were assessed before and after treatment.

RESULTS

Median adherence was 59.2% for nutrition and 83.0% for exercise. Compared with the LA group, the HA group had significantly smaller reductions in soft lean mass (- 4.1% vs. - 7.8%), skeletal muscle mass index (- 5.4% vs. - 9.5%), and bone mineral content (- 1.8% vs. - 6.0%) and greater fat mass reduction (- 18.8% vs. + 8.7%). Quadriceps strength was maintained in the HA group but declined in the LA group. Adverse events and CCRT completion rates did not differ between the groups.

CONCLUSION

Combined exercise and nutritional interventions are feasible during CCRT. Higher adherence may help preserve body composition and physical function, supporting the potential role of rehabilitation nutrition in supportive care for patients with HNC.