The Study: In the EAT trial, over 300 patients receiving comprehensive head and neck radiation were randomized +/- to a psychological eating behavior intervention to see if there were improvements in weight and nutritional status during treatment. The trial included a broad range of patient subtypes. Roughly one-third were receiving post-op radiation, and over 80% were receiving concurrent chemotherapy. In the control arm, dietitians provided routine care. In the intervention arm, trained dietitians met weekly during radiation and every two weeks after to perform cognitive behavioral therapy (CBT) and motivational interviewing (MI). The underlying principle was that, when guided by dietitians, patients themselves would argue for effective behavioral changes and devise concrete plans for implementation. In other words, there were no cookie-cutter dietary interventions. Unless the patient wanted cookies. Ultimately, EAT patients had significantly less weight loss, both in terms of fewer patients with >10% weight loss (34 → 27%) and a lower average weight loss (9.9 → 8.6%). Most importantly, they had significantly fewer treatment interruptions (14 → 8%).
Bottom Line: Dietitian-led cognitive behavioral therapy results in less weight loss and treatment interruptions during head and neck cancer radiation. | Britton, Int J Radiat Oncol Biol Phys 2018