3339 - The Impact of Stepwise Nutritional Intervention Combined with Individualized Nutritional Management on the Nutritional Status of Patients with Head and Neck Tumors Undergoing Radiotherapy: A Randomized Controlled Trial
Presenter(s)
J. Shi1, X. Long2, G. Xiang1, and Z. Lina1; 1Department of Radiation Oncology, Xijing Hospital, Air Force Medical University, xi an, shan xi, China, 2Department of Radiation Oncology, Xijing Hospital, Air Force Medical University, Xi'an, ShanXi, China
Purpose/Objective(s): This study aims to explore the impact of stepwise nutritional intervention combined with individualized nutritional management on the nutritional status of patients with head and neck tumors undergoing radiotherapy.
Materials/Methods: From October 2022 to October 2023, 80 patients who received radiotherapy for head and neck tumors in our hospital were randomly assigned in a 1:1 ratio to the conventional nutritional management group (control group) and the stepwise nutritional intervention combined with individualized nutritional management group (observation group), with 40 cases in each group. This study has been registered with the Chinese Clinical Trial Center (registration number: ChiCTR2300071214).The control group received conventional nutritional management, with doctors and nurses calculating the energy requirement per kilogram of body weight for each patient before outpatient radiotherapy, and nurses implemented routine nutritional management and dietary guidance. The observation group received stepwise nutritional intervention combined with individualized nutritional management on the basis of conventional nutritional management.For all patients, the main observation indicators (BMI) and secondary observation indicators, including total protein, hemoglobin, radioactive oral mucositis (graded according to the RTOG acute radiation injury grading criteria), psychological status (anxiety, SAS scale), and quality of life (QoL-C30), were collected before radiotherapy (within 1 week), during radiotherapy (at 20 fractions), at the end of radiotherapy (at 28 fractions), and 3 months after the end of radiotherapy.
Results: There were no significant differences in baseline data between the two groups. Compared with the control group, the observation group had significantly better nutritional status after radiotherapy, with BMI (19.23±3.64) vs (17.44±3.71) kg/m², p=0.032; Alb (42.65±4.06) vs (36.41±3.28) g/L, p=0.001; and Hb (132.94±10.06) vs (105.39±9.85) g/L, p=0.000. The incidence of severe oral mucositis (G3-4) was significantly lower in the observation group than in the control group (30% in the observation group vs 52% in the control group, p=0.024). The observation group had significantly better anxiety status after radiotherapy than the control group, with scores of (38.35±1.25) vs (47.55±1.62) after radiotherapy, p=0.002. The quality of life of the observation group was higher than that of the control group after intervention, with scores of (9.61±0.47) vs (8.63±0.27), p=0.000.
Conclusion: Stepwise nutritional intervention combined with individualized nutritional management can improve the nutritional status of patients with head and neck tumors undergoing radiotherapy, reduce the incidence of oral mucositis, alleviate the anxiety of patients during the radiotherapy process, and improve the quality of life of patients.