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Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

4916 - Prophylactic versus reactive enternal nutritional supplement in local advanced nasopharyngeal carcinoma patients receiving radical chemo-radiotherapy: A prospective, randomized, controlled clinical trial (NCT02948699)

Date

21 Oct 2018

Session

Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

Topics

Tumour Site

Head and Neck Cancers

Presenters

Yuan-yuan Chen

Citation

Annals of Oncology (2018) 29 (suppl_8): viii372-viii399. 10.1093/annonc/mdy287

Authors

Y. Chen1, S. Huang2, X. Chen1, Q. Hu1

Author affiliations

  • 1 Radiation oncology, Zhejiang cancer hospital, 310022 - Hangzhou/CN
  • 2 Radiation oncology, Zhejiang cancer hospital, 0571 - Hangzhou/CN
More

Resources

Abstract 4916

Background

The aim of this study was to investigate the effect of prophylactic versus reactive nutritional supplement on nutritional status and treatment tolerance in local advanced nasopharyngeal carcinoma (NPC) patients receiving neoadjuvant chemotherapy (NACT) and concurrent chemoradiotherapy (CCRT).

Methods

NPC patients were randomly assigned to prophylactic nutritional intervention group (A) or the control group (B). Patients in group A were supported with enteral nutrition supplement except daily diet from the beginning of radiotherapy (RT). Nutritional intervention aimed to reach 30 kcal/kg/d. Group B was treated with conventional diet guidance at first, appropriate nutritional intervention will be given when serious malnutrition (PG-SGA≥4) appeared. Weight and nutritional questionnaires (NRS 2002, PG-SGA) were collected at the baseline, before, during and after CCRT.

Results

From October 2016 to May 2018, 114 patients from our cancer center were randomly assigned to the group A and B (58 vs 56). The completion rates of NACT and RT were 88.6% and 100%. 80.7% of patients completed CCRT (A vs B = 90% vs 71%, P = 0.013, 95%IC=0.038-0.326). Grade 3/4 mucositis and grade 2/3 skin reaction were observed in 26.3% and 23.7% of patients. Though more serious radiation reactions were observed in group B, no statistical difference between group A and B (22.4% vs 30.4% and 21% vs 27%, P > 0.05). All patients experienced weight loss during the NACT and CCRT. Comparing to baseline, the rate of weight loss ≥5% and≥10% before, during, after RT and 1 month after RT were 3.5%, 28.9%, 29.8%, 64.7% and 0, 4.4%, 18.4%, 31%. The overall incidence of PG-SGA≥4 and ≥9 were32.6%, 39%, 95.9%, 100%, 78.7% and 2.3%, 10.5%, 50%, 72.3%, 14.8%, respectively. But the repeated measures showed that the difference of weight loss and PG-SGA scores between two groups were not significant (P > 0.05).

Conclusions

Malnutrition risk was gradually increased during the treatment of NPC.Prophylactic nutritional intervention can improve the tolerance of concurrent chemotherapy, but it has no advantage in weight loss and scores of short-term nutritional assessments.

Clinical trial identification

NCT02948699.

Legal entity responsible for the study

Zhejiang Cancer Hospital.

Funding

Nutricia.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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