431MO - Cost-effective evaluation of homemade diet recipe in head and neck cancer patients during radiotherapy from low-middle-income group countries

Background

Radiotherapy is an integral part of treatment in head and neck cancer patients. These patients are at a high-risk of malnutrition during and after the course of treatment. In low-middle-income group countries (LMICs), patients are mostly undernourished. They need cost-effective, easily available, and acceptable nutritional support. The study has looked at the effectiveness of homemade vs commercially available nutritional supplements.

Methods

Homemade diet recipes were designed using low-cost and locally available ingredients according to the taste of local people to fulfill the daily calorie requirement of ≈2,000 kcal (30 kcal/kg for a 65 kg adult) with ≥90 gm of protein (1.5 gm/kg). Alongside, five commercial nutritional supplements were evaluated to meet the above requirements. 50 consecutive patients of head and neck cancer on radiotherapy were included. Group A of 25 patients were given a homemade diet recipe and group B of 25 patients were given a commercially available nutritional supplement of their choice.

Results

The caloric content (380 ± 80.1 kcal/100 gm, 260–474 kcal) and protein contents (32.6 ±10.9/100 gm, 15–49 gm) in commercial supplements were variable. For providing 2,000 kcal with a minimum of 90 gm protein, the cost of commercial formulations ranged from INR 745-3,461/day (1,700 ± 946). Comparatively, homemade recipes were estimated to cost just INR 135/day. For the 2000 kcal diet, the difference in nutrient contents of commercial vs homemade preparations were nonsignificant, while the cost was significantly lower with homemade recipes (p=0.03). Both the cohorts were well matched. Mean weight loss at the end of treatment in group A was 3 kgs (2.1-3.5) whereas that was 5.7kg(3.5-6.9) in group B(p=0.01). 20%(n=5) patients required hospital admission for supportive care in group A and 36%(n=9) in group B. After 6 weeks of completion of treatment mean weight gain in group A was 4.6kg (3.9-5.5kg) whereas in group B was 2.4 kg(1.8-3kgs)(p=0.03).

Conclusions

Homemade diet recipes are highly effective to fulfill the compromised nutritional needs during radiotherapy in head and neck cancer patients. It is acceptable, palatable, cheap and thereby especially suit patients from LMICs.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

P.B. Kalbande.

Funding

Has not received any funding.

Disclosure

The author has declared no conflicts of interest.