Authors (including presenting author) :
Sit J(1), Yuen KS(1), Yu MWV(1)
Affiliation :
(1)Department of Dietetics, Queen Mary Hospital
Introduction :
NPC Patients receiving RT face challenges in achieving elevated nutritional requirement as their intake is affected both by the tumor and the side effects of treatment.
Objectives :
The aim of this study is to determine the impact of early and intensive dietetic intervention using a well-defined protocol by evaluating related outcomes including body composition and Patient Generated Subjective Global Assessment Short Form (PG-SGASF) score.
Methodology :
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 was collected by PGSGASF. Body composition was analyzed with Biometric Impedance Analyzer. Thirty patients complied with the protocol and were selected for the study.
Result & Outcome :
Patients experienced significant body weight(BW) loss from 64.31±14.12kg to 58.40±12.81kg(p< 0.00) and Body Mass Index(BMI) reduction from 23.91±3.68kg/m2 to 21.72±3.37kg/m2(p< 0.00) after RT. Weight loss(-5.91±3.62kg) was comparable to China(-3 to -7.7kg). Muscle mass significantly(p< 0.00) reduced from 45.6±9.0kg to 42.35±7.9kg(-3.2±2.3kg), which was less than Hong Kong’s reference(-4.1kg) but higher than that in China(-1.54kg). No significant change(p=0.36) in fat(-0.96±5.12%) was noted. Similar to China’s researches(-1.7 to -2g/L), serum albumin significantly dropped from 44±3g/L to 42±5g/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 like taste alteration, mucositis and pain aggravate towards the end of treatment. Patients’ energy intake and energy intake/kg BW diminished significantly(p< 0.00) from 1882±446kcal to 1331±486kcal and 29.6±5.1kcal/kg to 23.9±10kcal/kg respectively. Protein intake/kg BW also plunged from 1.3±0.4g/kg to 1.1±0.4g/kg(p< 0.00). This study showed that our early and intensive dietetic intervention was effective resulting in less weight and muscle loss, similar albumin reduction and fat conservation for NPC patients receiving RT. Such maintenance of their nutritional status would enhance their tolerance to RT with better treatment outcome. In addition, this was achieved without the financial incentive or convenience of providing free dietary supplements as in other places.
