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

摘要

Background: NPC Patients receiving RT face challenges in achieving elevated nutritional requirement. Aim: To determine the impact of early and intensive dietetic intervention with well-defined protocol by evaluating related outcomes and Patient Generated Subjective Global Assessment Short Form (PG-SGASF) score. Methods: Since 2018, NPC patients on RT were seen by clinical dietitians before, during and 2 weeks after RT. Information on intake, symptoms and functional status were collected. Thirty patients were selected for the study. Results: Patients experienced significant body weight (BW) loss from 64.31 ± 14.12 kg to 58.40 ± 12.81 kg (P < 0.00) and Body Mass Index (BMI) reduction from 23.91 ± 3.68 kg/m~2 to 21.72 ± 3.37 kg/m~2 (P < 0.00) after RT. Weight loss (-5.91 ± 3.62 kg) was comparable to China (-3 to -7.7 kg). Muscle mass significantly (P < 0.00) reduced from 45.6 ± 9.0 kg to 42.35 ± 7.9 kg (-3.2 ± 2.3 kg), which was less than Hong Kong's reference (-4.1 kg) but higher than China's (-1.54 kg). No significant change (P = 0.36) in fat (-0.96 ± 5.12%) was noted. Serum albumin significantly dropped from 44 ± 3 g/L to 42 ± 5 g/L (P < 0.02) after RT. Phase angle diminished from 5.83 ± 0.77° to 5.33 ± 0.72°(-5.7 ± 9.9°) (P < 0.00) after RT which was higher than western's data (-0.2 to -0.22°). PG-SGASF score increased significantly (P < 0.00) from 4 ± 4 to 10 ± 7 after treatment as side effects of treatment aggravated. Patients' energy intake/kg BW diminished significantly (P < 0.00) from 29.6 ± 5.1 kcal/kg to 23.9 ± 10 kcal/ kg respectively. Protein intake/kg BW also plunged from 1.3 ± 0.4 g/kg to 1.1 ± 0.4 g/kg (P < 0.00). Conclusions: Our early and intensive dietetic intervention was effective in resulting less weight and muscle loss, similar albumin reduction and fat conservation for NPC patients receiving RT, which was achieved without the free provision of dietary supplements as in other places.