MS30.05 Nutritional Management During Radical Radiotherapy

Abstract

Curative intent fractionated external beam radiotherapy (RT) with or without chemotherapy is used to treat locally advanced non-small cell cancer (NSCLC) and common side effects include anorexia, oesophagitis and fatigue, all of which can all impact on nutritional status. Previous research has shown that up to one third of lung cancer patients treated with RT experience clinically significant weight loss1 while one third of lung cancer patients present with malnutrition prior to even commencing RT 2. The negative impact of weight loss and malnutrition on patient and clinical outcomes is well established across all modes of cancer treatment including chemoradiotherpy3. There is limited evidence available relating to effective nutritional support strategies to prevent or treat weight loss and malnutrition in lung cancer4. There may be a role for enteral feeding where severe oesophagitis occurs in order to support patients through radical radiotherapy and its recovery1. The nutrition intervention demonstrated to be most effective in other tumours undergoing radiotherapy treatment is intensive individualised dietary counselling5 and the presence of dedicated dietetic services to head and neck and oesophageal cancer patients is well established in the U.K with dietitians identified as core members of the multi-disciplinary team. This session will explore the impact of a worsening nutritional status on clinical and patient outcomes and discuss the nutritional interventions that may be of benefit. It will also consider the role of a dedicated lung cancer dietitian and the impact this can have on patients with lung cancer. 1. Kiss, N., Isenring, E., Gough, K. et al (2014) The prevalence of weight loss during (chemo)radiotherapy treatment for lung cancer associated patient- and treatment-related factors. Clin Nutr, 33: 1074-1080 2. Unsal, D., Bulent, M., Akmansu, M. et al (2006) Evaluation of nutritional status in cancer patients receiving radiotherapy. Am J Clin Oncol 29: 183-188 3. Sanders, K., Hendricks, L., Troost. et al. (2016) Early weight loss during chemoradiotherapy has a detrimental impact on outcome in NSCLC. J Thor Oncol, 11: 873-879 4. Kiss, N., Krishnasamy, M. and Iserning, E. (2013) The effects of nutrition intervention in lung cancer patients undergoing chemotherapy and/or radiotherapy: a systematic review. Nutr Cancer, 66: 47-56 5. Lee, J., Leong L. and Lim, S. (2016) Nutrition intervention approaches to reduce malnutrition in oncology patients: a systematic review. Support Care Cancer, 24: 469-480. radical radiotherapy, NSCLC, nutrition