Evaluation of the nutritional pathway for patients at risk of malnutrition undergoing radiotherapy
Stefania Caponigro,
Italy
PO-1080
Abstract
Evaluation of the nutritional pathway for patients at risk of malnutrition undergoing radiotherapy
Authors: Velia Forte1, Flavio I. Pancione1, Veterina De Simone1, Luigi Sabatino1, Debora Di Minico1, Stefania Caponigro1, Francesca Cavallo1, Simona Borrelli1, Ivana Russo1, Gessica Abate1, Giuliana Russo1, Natascia Gennuso1, Piercarlo Gentile1,2
1UPMC Villa Maria Hillman Cancer Center, Radiotherapy, Mirabella Eclano (AV), Italy; 2UPMC San Pietro FBF, Radiotherapy, Roma, Italy
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Purpose or Objective
Malnutrition and weight loss frequent affect cancer patients and can represent an obstacle to radiotherapy treatment, involving: need for re-simulations and re-planning because of modification of the target volumes, risk of interruption for asthenia or for the worsening of the patient's quality of life. Screening and nutritional interventions can support patients with eating disorders. Therefore, UPMC Villa Maria Radiotherapy Cancer Center has introduced a nutritional pathway, with the aim of improve patient’s quality life and optimize compliance with treatments.
Material and Methods
725 patients treated between January 2019 and December 2021 were analyzed. Some of those patients received a resimulation during treatment course: out of 86 total re-simulations, 19 are attributable to weight loss (about 22%). For the activation of the nutritional clinical pathway, a new protocol has been established from March 2022, which provides:
- an alert system to identify patients at risk, implemented mainly by radiation oncologist and nurses during the first visit and on treatment visits (OTVs), and by radiotherapy therapists, performing the daily patient’s imaging;
- consultation with the nutritionist, administrating the EORTC QLQ-C30 test and drafting of a personalized nutritional plan; the specialist also establishes the objective of the treatment path as weight loss or maintenance or weight gain, depending on the case;
- monitoring of nutritional status during OTVs and follow-ups (FUPs), in which the EORTC QLQ-C30 test is repeated, to be compared with the previous ones.
Since the start of the nutritional support pathway to October 2022, 15 patients at risk of malnutrition have been selected, to collect data from tests carried out, on the weights and on the MUST indicator (Malnutrition Universal Screening Tool).
Results
In 92% of the cases analyzed, the MUST was maintained at a score >2. Out of 25 resimulations carried out from March to October 2022, only one is due to weight loss (4%), with a significantly lower trend than the pre-implementation reference (Table 1).
The results are:
- an improvement of patient satisfaction;
- an incisive optimization of human and economic resources, and materials involved.
Conclusion
From our experience, having a nutrition clinical pathway during radiotherapy curses is necessary to guarantee the best treatment conditions to the patient, and improve his quality of life.
The new nutrition protocol was welcomed by all the staff of our cancer center with enthusiasm, thanks to the synergistic work daily performed by the various professionals involved.
Furthermore, by comparing the results of the EORTC QLQ-C30 tests and the MUST indicators detected at the FUPs with the previous ones, it will be possible to evaluate the impact of the nutritional path carried out by the patient over time. Our future purpose of the study is to improve the results obtained.