Assessment and Comparison of Nutritional Status in Cancer Patients at the Onset and the End of Radiotherapy

Abstract

Background and Objective: Malnutrition is prevalent in cancer patients and is one of the major factors in morbidity and mortality. Malnutrition can be resulted of local and systemic tumor or side effects of anticancer treatments especially radiotherapy. Malnutrition plays an important role in decreased response and tolerance to radiotherapy. Therefore this prospective study was carried out with aim of determining and comparing nutrition status before and at the end of radiotherapy in cancer patients. Material and methods: The nutritional status of 61 volunteer cancer patients with mean age of 53±16 years who were referred to the radiotherapy center of Imam Khomeini hospital was evaluated. Nutritional status was evaluated by standard questionnaire patient- generated global assessment (PG-SGA), dietary intakes of 3 days were assessed by using 24-hour recall food questionnaire method. Results: The nutritional status of patients on the basis of well nourished, moderate malnutrition and severe malnutrition category before radiotherapy were 44.3%, 32.8%, 23% , whilst, at the end of radiotherapy were 32.8%, 26.2% and 41% respectively and the percentage of increase in malnutrition were statistically significant (p= 0.008). The mean daily energy intake, percentage of energy from carbohydrate, protein and fat before radiotherapy were 1900±111.6 (kcal), 55%±1.5, 16%±0.83, 28%±1.3 and at the end of radiotherapy were 1500±175.3 (kcal), 55%±2.0, 16%±1.3, 28%±1.6 respectively. Despite the reduction of energy intake the difference was not significant. A significant decrease in body weight (p=0.001) and body mass index (p= 0.002) at the end of radiotherapy was observed in all patients. Symptoms which may reduce nutritional intake such as anorexia, dry mouth, nausea, vomiting and hypogeusia were worsen (except vomiting) after treatment. Conclusion: For getting the best outcome from treatment nutritional assessment should be an integral part of therapy for every cancer patient especially before and during radiotherapy and proper nutritional (enteral tube and parenteral feeding) interventions should be made available to the patients.