Evaluation of Nutritional Status in Cancer Patients Receiving Radiotherapy: A Prospective Study

Objectives:The purpose of the present study was to evaluate the nutritional status of cancer patients receiving radiotherapy (RT) and to assess the possible contributions of nutritional support to patients with malnutrition. Methods:Prospectively, 207 patients referred to our outpatient radiotherapy department were included. The patients were classified according to tumor site (head/neck, breast, lung, stomach, or colorectal). Nutritional status at the onset, at the end of RT, and 3 and 6 months after irradiation was evaluated with the subjective global assessment (SGA). All of the patients were supported with additional portions of meal or standard enteral feeding formula during and after the irradiation period as long as they were in the moderately or severely malnourished groups, respectively. Results:At the onset, malnutrition was present in 31% of all patients, and it increased to 43% at the end of RT. This difference predominated in head/neck cancer patients. Malnutrition ratios in head/neck cancer patients at the onset and after RT were 24% and 88%, respectively. By a 6-month follow-up, the ratio of patients with malnutrition decreased to 8%. Nutritional status of all groups was found to improve during the 6-month follow-up period, except for the breast cancer group, which included no patients with severe malnutrition at any time. Conclusion:The results of the present study may be helpful in planning an appropriate nutritional support for cancer patients undergoing radiotherapy according to the irradiation site.

[1]  P. Ravasco,et al.  Impact of nutrition on outcome: A prospective randomized controlled trial in patients with head and neck cancer undergoing radiotherapy , 2005, Head & neck.

[2]  P. Ravasco,et al.  Dietary counseling improves patient outcomes: a prospective, randomized, controlled trial in colorectal cancer patients undergoing radiotherapy. , 2005, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[3]  M. Elia,et al.  Malnutrition in hospital outpatients and inpatients: prevalence, concurrent validity and ease of use of the ‘malnutrition universal screening tool’ (‘MUST’) for adults† , 2004, British Journal of Nutrition.

[4]  J. Bauer,et al.  Nutrition intervention is beneficial in oncology outpatients receiving radiotherapy to the gastrointestinal or head and neck area , 2004, British Journal of Cancer.

[5]  M. Akmansu,et al.  Results of chemoirradiation after curative resection of locally advanced gastric cancer , 2004, International journal of clinical practice.

[6]  P. Ravasco,et al.  Does nutrition influence quality of life in cancer patients undergoing radiotherapy? , 2003, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[7]  R. Mirimanoff,et al.  Early nutritional intervention in oropharyngeal cancer patients undergoing radiotherapy , 2002, Supportive Care in Cancer.

[8]  M. Gotteland,et al.  Acute Nutritional and Intestinal Changes after Pelvic Radiation , 2001, Journal of the American College of Nutrition.

[9]  P Beach,et al.  Relationship between fatigue and nutritional status in patients receiving radiation therapy to treat lung cancer. , 2001, Oncology nursing forum.

[10]  T. Mekhail,et al.  Enteral nutrition during the treatment of head and neck carcinoma , 2001, Cancer.

[11]  A. Williams,et al.  Nutrition During and After Cancer Treatment: A Guide * for Informed Choices by Cancer Survivors , 2001, CA: a cancer journal for clinicians.

[12]  E. Erkurt,et al.  Supportive treatment in weight-losing cancer patients due to the additive adverse effects of radiation treatment and/or chemotherapy. , 2000, Journal of experimental & clinical cancer research : CR.

[13]  A. Dursun,et al.  Double-blinded, randomized, placebo-controlled study to evaluate the effectiveness of sulphasalazine in preventing acute gastrointestinal complications due to radiotherapy. , 2000, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[14]  A. V. van Geel,et al.  Morbidity of immediate breast reconstruction (IBR) after mastectomy by a subpectorally placed silicone prosthesis: the adverse effect of radiotherapy. , 2000, European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology.

[15]  H. Sayan,et al.  The effect of granulocyte macrophage-colony stimulating factor on the prostaglandin E(2)-like activity of the small intestine of rat during total body irradiation. , 2000, Prostaglandins, leukotrienes, and essential fatty acids.

[16]  G. Nitenberg,et al.  Nutritional support of the cancer patient: issues and dilemmas. , 2000, Critical reviews in oncology/hematology.

[17]  Y. Shim,et al.  Postoperative adjuvant therapy for stage II non-small-cell lung cancer. , 1999, The Annals of thoracic surgery.

[18]  J. Battermann,et al.  A prospective study on quality of life of laryngeal cancer patients treated with radiotherapy , 1999, Head & neck.

[19]  M. Ferguson,et al.  Development of a valid and reliable malnutrition screening tool for adult acute hospital patients. , 1999, Nutrition.

[20]  D. Cowen,et al.  A randomized double blind placebo controlled multicenter study of mesalazine for the prevention of acute radiation enteritis. , 1997, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[21]  A. Hunter Nutrition management of patients with neoplastic disease of the head and neck treated with radiation therapy. , 1996, Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition.

[22]  L. Peters Radiation therapy tolerance limits: For one or for all?‐Janeway lecture , 1996, Cancer.

[23]  Randy L. Moore,et al.  Olsalazine is contraindicated during pelvic radiation therapy: results of a double-blind, randomized clinical trial. , 1996, International journal of radiation oncology, biology, physics.

[24]  S. Heys,et al.  Cancer cachexia: pathophysiological mechanisms. , 1996, European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology.

[25]  F. Ottery,et al.  Definition of standardized nutritional assessment and interventional pathways in oncology. , 1996, Nutrition.

[26]  Ottery Fd Rethinking nutritional support of the cancer patient: the new field of nutritional oncology. , 1994 .

[27]  F. Ottery Rethinking nutritional support of the cancer patient: the new field of nutritional oncology. , 1994, Seminars in oncology.

[28]  F. Ottery Cancer cachexia: prevention, early diagnosis, and management. , 1994, Cancer practice.

[29]  A. Michalowski On radiation damage to normal tissues and its treatment. II. Anti-inflammatory drugs. , 1994, Acta oncologica.

[30]  J. Moran,et al.  Nutritional evaluation and dietetic care in cancer patients treated with radiotherapy: prospective study. , 1991, Nutrition.

[31]  J. Beatty,et al.  Predicting the need for prolonged enteral supplementation in the patient with head and neck cancer. , 1988, American journal of surgery.

[32]  A S Detsky,et al.  What is subjective global assessment of nutritional status? , 1987, JPEN. Journal of parenteral and enteral nutrition.

[33]  W. Schofield Predicting basal metabolic rate, new standards and review of previous work. , 1985, Human nutrition. Clinical nutrition.

[34]  S. Donaldson Nutritional consequences of radiotherapy. , 1977, Cancer research.