Early and intensive dietetic intervention on the nutritional status of nasopharyngeal cancer (NPC) patients undergoing radiotherapy (RT)

Abstract Background The prevalence of malnutrition amongst pancreatic cancer patients is widely reported. This is due to reduced nutritional intake, increased energy expenditure and increased nutrient losses secondary to malabsorption. A Whipple's procedure or pancreaticoduodenectomy is the only potentially curable intervention for pancreatic cancer patients. Malnutrition is associated with increased peri and post-operative complications including delayed wound healing, longer hospital admission and higher mortality rate. Dietetic prehabilitation is a proactive intervention to assess patients’ nutritional status in preparation for elective surgery and, through early dietetic intervention, has the potential to improve perioperative outcomes. This pilot study reviewed the severity of nutritional risk in both the pre and post-operative stages to understand the need for dietetic prehabilitation in this patient group. Methods All patients referred were nutritionally assessed as part of a dietetic cancer prehabilitation pathway, which includes pre-surgical nutritional assessment within one week of referral and early post discharge nutritional assessment. Nutritional assessment was carried out using the PG-SGA short form and patients were triaged as requiring either a universal, targeted or specialist dietetic intervention dependent on severity of nutritional risk. Patients who scored <4 were triaged as universal, and were low nutritional risk. Patients who scored 5-9 were triaged as targeted and were medium nutritional risk, and patients who scored >9 were triaged as specialist, and were high nutritional risk. Results 35 patients were referred for dietetic prehabilitation assessment. 71% of patients were triaged as requiring either a targeted or specialist prehabilitiation intervention. BMI ranged from 15.7kg/m² to 35.9kg/m² and median weight loss was 10.0%. 23 patients received early post surgical nutritional assessment, within 12 days of discharge from hospital. All 23 patients required targeted or specialist dietetic intervention. 22 patients reported post-operative weight loss, with a median weight loss of 7.5%. There was no correlation between pre-surgical and post-surgical nutritional risk. Conclusions Patients undergoing pancreaticoduodenectomy are at high nutritional risk in both the pre and post-operative periods. Patients without evidence of malnutrition in the pre-operative stage remain at high risk of malnutrition and the associated complications in the post operative stage. A prehabilitation programme can identify patients at nutritional risk and institute interventions to optimise perioperative nutritional status. Findings from this review will form the basis of a study examining the effects of a prehabilitation programme on outcomes following pancreaticoduodenectomy.

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Tolerability of the Intergroup 0099 regimen in locally advanced nasopharyngeal cancer with a focus on patients' nutritional status

Journal of Clinical Oncology ◽

10.1200/jco.2004.22.14_suppl.5572 ◽

2004 ◽

Vol 22 (14_suppl) ◽

pp. 5572-5572

Author(s):

M. Bahl ◽

L. L. Siu ◽

G. R. Pond ◽

J. Kim ◽

I. F. Tannock ◽

...

Keyword(s):

Nutritional Status ◽

Locally Advanced ◽

Nasopharyngeal Cancer

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Nutritional status and symptom burden in advanced non-small cell lung cancer: results of the dietetic assessment and intervention in lung cancer (DAIL) trial

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2020-002838 ◽

2021 ◽

pp. bmjspcare-2020-002838

Author(s):

Iain Phillips ◽

Lindsey Allan ◽

Adele Hug ◽

Naomi Westran ◽

Claudia Heinemann ◽

...

Keyword(s):

Lung Cancer ◽

Weight Loss ◽

Nutritional Status ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Symptom Burden ◽

Small Cell ◽

Nutritional Deficiencies ◽

Small Cell Lung ◽

Dietetic Intervention

IntroductionEuropean Society for Clinical Nutrition and Metabolism guidelines recommend that patients with cancer should be screened for malnutrition at diagnosis. The dietetic assessment and intervention in lung cancer study investigated the nutritional status of patients with non-small cell lung cancer (NSCLC) and the need for dietetic intervention.MethodsIn this observational cohort pilot study, patients with stage 3b and 4 NSCLC were assessed prior to starting first line systemic anticancer therapy (SACT) with a range of measurements and questionnaires. We report the outcomes related to the Patient Generated Subjective Global Assessment tool (PG-SGA),Results96 patients were consented between April 2017 and August 2019. The PG-SGA identified that 78% of patients required specialist nutritional advice; with 52% patients having a critical need for dietetic input and symptom management. Results were dominated by symptom scores. As a screening test, one or more symptoms or recent weight loss history had a sensitivity of 88% (95% CI 78.44% to 94.36%) and specificity of 95.24% (95% CI 76.18% to 99.88%) for need for dietetic intervention.ConclusionA large proportion of patients with NSCLC have a high symptom burden and are at risk of malnutrition prior to starting SACT and would benefit from dietetic review. It is imperative that oncologists and healthcare professionals discuss weight loss history and symptoms with lung cancer patients to correct nutritional deficiencies and resolve symptoms prior to starting treatment.

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Impact of Dietetic Intervention on Skin Autofluorescence and Nutritional Status in Persons Receiving Dialysis: A Proof of Principle Study

Journal of Renal Nutrition ◽

10.1053/j.jrn.2019.12.006 ◽

2020 ◽

Vol 30 (6) ◽

pp. 540-547 ◽

Cited By ~ 3

Author(s):

Daniela Viramontes Hörner ◽

Fiona C. Willingham ◽

Nicholas M. Selby ◽

Maarten W. Taal

Keyword(s):

Nutritional Status ◽

Skin Autofluorescence ◽

Proof Of Principle ◽

Dietetic Intervention

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Tolerability of the Intergroup 0099 regimen in locally advanced nasopharyngeal cancer with a focus on patients' nutritional status

Journal of Clinical Oncology ◽

10.1200/jco.2004.22.90140.5572 ◽

2004 ◽

Vol 22 (14_suppl) ◽

pp. 5572-5572

Author(s):

M. Bahl ◽

L. L. Siu ◽

G. R. Pond ◽

J. Kim ◽

I. F. Tannock ◽

...

Keyword(s):

Nutritional Status ◽

Locally Advanced ◽

Nasopharyngeal Cancer

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Nutritional outcomes after radiotherapy target volume reduction for nasopharyngeal cancer: a Phase III trial

Future Oncology ◽

10.2217/fon-2019-0785 ◽

2020 ◽

Author(s):

Li Xiang ◽

Jin-Feng Rong ◽

Hao-Wen Pang ◽

Huai-Lin He ◽

Yue Chen ◽

...

Keyword(s):

Nutritional Status ◽

Gross Tumor Volume ◽

Tumor Volume ◽

Nasopharyngeal Cancer ◽

Intensity Modulated Radiotherapy ◽

Target Volume ◽

Phase Iii ◽

Poor Nutritional Status ◽

Group A ◽

Group B

Aim: This study aimed to assess the nutritional status of patients with locoregionally advanced nasopharyngeal cancer, for whom intensity-modulated radiotherapy (IMRT) was planned using their pre- or post-induction chemotherapy (IC) nasopharyngeal gross tumor volume. Materials & methods: Two-hundred twelve cases of stage III–IVb nasopharyngeal cancer were randomized into groups A (n = 97) and B (n = 115). IMRT was planned for groups A and B using pre-IC and post-IC images, respectively. Results: There was a significant decrease in the nutritional parameters of group B compared with those of group A during radiotherapy. Multivariate analysis indicated that the T stage and nasopharyngeal gross tumor volume IMRT-planning protocol were prognostic factors of poor nutritional status. Conclusion: Decreasing the IMRT target volume through IC can improve nutritional status.

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Tolerability of the Intergroup 0099 (INT 0099) regimen in locally advanced nasopharyngeal cancer with a focus on patients' nutritional status

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2004.05.011 ◽

2004 ◽

Vol 60 (4) ◽

pp. 1127-1136 ◽

Cited By ~ 18

Author(s):

Mala Bahl ◽

Lillian L. Siu ◽

Gregory R. Pond ◽

John Kim ◽

Ian F. Tannock ◽

...

Keyword(s):

Nutritional Status ◽

Locally Advanced ◽

Nasopharyngeal Cancer

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THE RELATIONSHIP BETWEEN THE STAGE OF NASOPHARYNGEAL CARCINOMA WITH ANEMIA AND NUTRITIONAL STATUS IN WEST NUSA TENGGARA GENERAL HOSPITAL

INTERNATIONAL JOURNAL OF NASOPHARYNGEAL CARCINOMA (IJNPC) ◽

10.32734/ijnpc.v2i01.3579 ◽

2020 ◽

Vol 2 (01) ◽

pp. 15-17

Author(s):

Ni Ketut Susilawati ◽

Hamsu Kadriyan ◽

Wayan Putu Sutirtayasa

Keyword(s):

Nasopharyngeal Carcinoma ◽

Nutritional Status ◽

Malignant Tumors ◽

Nasopharyngeal Cancer ◽

P Value ◽

Cross Sectional ◽

Normality Test ◽

Significant Difference ◽

Relationship Of ◽

The Relationship

Introduction: Nasopharyngeal carcinoma is the most common malignant tumor in the ENT-HNS were the highest of all malignant tumors of the head and neck. Malnutrition and cachexia is a common problem in cancer patients and impact on quality of life and survival. Anemia is a major problem in patients with nasopharyngeal cancer receiving chemotherapy or radiotherapy. Objective: Determine the relationship of nasopharyngeal carcinoma stage with anemia and nutritional status. Material and methods: This study used cross sectional analytic method. Data were obtained from medical records of patients with nasopharyngeal carcinoma who were treated in province hospital West Nusa Tenggara period January 2018 to December 2018. Data collected include the identity, diagnosis, hemoglobin value, weight and height. Having analyzed the data collected are looking for is there a relationship between stage nasopharyngeal carcinoma with anemia and nutritional status. Results: In this study, Shapiro-Wilk normality test. Anova is then performed to analyze the relationship stage nasopharyngeal carcinoma with anemia status obtained 95% CI, p value 0.847, there is no difference between stage nasopharyngeal carcinoma with anemia. Kruskal Wallis test to analyze the relationship with BMI (body mass index) with stage nasopharyngeal carcinoma obtained 95% CI, p value 0.565. There is no difference in BMI with stage nasopharyngeal carcinoma. Conclusion: There is a tendency to lower Hb in patients with nasopharyngeal cancer further stage although there is no significant difference between each stage. The same thing was found in BMI, BMI decreased tendency in patients with advanced nasopharyngeal cancer although there was no statistically significant difference.

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