NUTRITIONAL STATUS IN PAEDIATRIC CANCER PATIENTS AFFECTED BY SARCOMA: A 5-YEAR RETROSPECTIVE ANALYSIS

Abstract

Evaluation of the nutritional status of a pediatric population affected by osteosarcoma(OS), rhabdomyosarcoma (RMS) and Ewing's sarcoma (EWS), at diagnosis and during treatment. Consecutive patients (pts) aged 0-18 affected by OS, RMS and EWS, attending the Pediatric Oncology Unit since 01/2013 to 12/2017, were evaluated; medical records were reviewed. Anthropometric data (BMI z-score) were collected at T0 (diagnosis), T1 (4-6 months, during treatment) and T2 (8-12 months, follow-up). The non parametric Wilcoxon-Mann-Whitney test was applied to compare the distribution of the BMI z-score between the three times. Nutritional intervention was recorded. Complete data were available for 120 pts: 43 OSpts, 31 RMSpts and 46 EWSpts. Severe malnutrition (z-score<-2) at diagnosis was recorded in 4% of OSpts, 4.6% of RMSpts, 4% of EWSpts; at baseline, median z-score was -0.71(IQR:-1.25–0.53) in OS, -0.72(IQR:-1.18–0.75) in RMS, -0.05(IQR:-0.92–1) in EWS. A significant worsening was observed at T1 overall (p=0.008) and in OS (p<0.001). T2 shows a significant global improvement (p=0.02). Comparing T0-T2, the worsening is significant only for Ospts (median z-score – 0.98, p=0.036), z-score in the other groups improves during follow-up. Parenteral Nutrition (PN) was applied in 45 pts (37.5%), primarily during high-dose-chemoterapy and autologous transplant in EWSpts. Analysis of the correlation with adverse effects wasn't possible because of missing data. Z-score<-2 at T2 was recorded in 12% of OSpts, 5.3% of RMSpts, 7.3% of EWSpts. A significant deterioration of nutritional status during oncologic treatment was observed, especially in OS patients. PN was applied in limited cases (high-dose-chemoterapy and autologous transplant). Screening and follow-up of patients are advisable since diagnosis, for a better and timely nutritional intervention.