4822 - Efficiacy of different nutritional intervention on nutritional status and quality of life for local advanced nasopharyngeal carcinoma patients: a prospective clinical trial

Background

Local advanced nasopharyngeal carcinoma (NPC) patients receiving neoadjuvant chemotherapy (NACT) and concurrent chemoradiotherapy (CCRT) suffered from malnutrition and declining quality of life. We investigate the impact of prophylactic or reactive nutritional support on nutritional status and quality of life.

Methods

Enrolled patients were randomly assigned to receive prophylactic (group A) or reactive nutrition intervention (group B). Group A was supported with enteral nutrition beyond daily diet from the beginning of radiotherapy (RT). Group B was treated with conventional diet guidance, appropriate nutritional intervention will be given when needed. Patients were asked to complete the EORTC QLQ-C30 and QLQ-H&N35 questionnaires at the baseline, before, during and after CCRT. Weight and hematological indexes were also collected. Statistical analyses are using SPSS 18.0.

Results

From October 2016 to May 2018, 114 patients were randomly assigned into the group A (n = 58) and B (n = 56). 80.7% of patients completed concurrent chemotherapy (A vs B = 90% vs 71%, P = 0.013, 95%IC=0.038-0.326). All patients experienced weight loss during the CCRT. Comparing to baseline, the rate of weight loss ≥5% before, during, at the end of RT and 1- and 3-month after RT were 3.5%, 28.9%, 29.8%, 64.7% and 33.2%. After treatment, Total serum protein and albumin of group A were better than B (68.7±6.31 vs 65.6±5.27 g/L, p = 0.003 and 41.86±4.05 vs 39.52±3.93 g/L, p = 0.001). Incidence of anemia at these times were 2%,37%,53%,55% and 19%. But no differences were found in two groups. Global health status scores in QLQ-C30 and QLQ-H&N35 decreased during NAT and CCRT. After RT, quality of life issues significant improved at the 1-and 3-months follow-up comparing to the end of treatment (65.34 and 76.4 vs 39.8, p = 0.00). But no statistical advantages of QoL were found in Patients in group A except feeling ill.

Conclusions

The nutrition status and QoL of NPC patients decreased during treatment. Though prophylactic nutritional intervention can enhance the completion of concurrent chemotherapy and keep the plasma protein stable, but it has no advantage in weight loss and quality of life except feeling ill.

Clinical trial identification

NCT02948699.

Editorial acknowledgement

Legal entity responsible for the study

Zhejiang Cancer Hospital.

Funding

Nutricia.

Disclosure

All authors have declared no conflicts of interest.