Validation of a simple diet self-assessment tool (SDSAT) in head and neck cancer patients undergoing radiotherapy

Prevalence of Malnutrition in Patients with Hepatocellular Carcinoma: A Comparative Study of GLIM Criteria, NRS2002, and PG-SGA, and Identification of Independent Risk Factors

AIM

Malnutrition is prevalent in hepatocellular carcinoma (HCC) patients, linked to poor outcomes, necessitating early intervention. This study aimed to investigate malnutrition in HCC patients, assess Nutrition Risk Screening 2002 (NRS-2002) and Patient-Generated Subjective Global Assessment (PG-SGA) vs. Global Leadership Initiative on Malnutrition (GLIM) criteria, and identify independent risk factors.

METHOD

A cross-sectional retrospective study was conducted on 207 patients with HCC. Nutritional screening/assessment results and blood samples were collected within 72 h of admission. This study assessed the prevalence of malnutrition using the NRS-2002 and PG-SGA and retrospectively using the GLIM criteria. The performance of the screening tools was evaluated using kappa (K) values. Logistic regression analyses were performed to determine whether laboratory parameters were associated with malnutrition as identified by the GLIM criteria.

RESULTS

Of the participants, 30.4% were at risk of malnutrition according to NRS-2002. The agreement between the NRS-2002 and GLIM criteria was substantial. The GLIM criteria and PG-SGA diagnosed malnutrition in 43 and 54.6% of the participants, respectively. Age, anemia, and ascites correlated with malnutrition in regression.

CONCLUSION

The GLIM criteria, along with NRS-2002 and PG-SGA, aid in diagnosing malnutrition in HCC patients. Recognizing risk factors improves accuracy, enabling timely interventions for better outcomes.

Dynamic changes in the body composition during chemotherapy for gastrointestinal tumors in the context of active nutrition intervention

Objective

To explore the dynamic changes in the body composition during chemotherapy in patients with gastrointestinal malignancies in the context of active nutrition intervention.

Methods

Patients with gastrointestinal malignancies receiving first-line chemotherapy in the Department of Medical Oncology of Ordos Central Hospital from September 2019 to January 2022 were included in this study. The Nutritional Risk Screening form 2002, Patient-Generated Subjective Global Assessment form, bioelectrical impedance analysis, and dynamic changes in L3 skeletal muscle index (SMI) (L3SMI) were assessed at baseline and after chemotherapy. The recommended protocol of the Nutrition Guidelines for Cancer Patients in China 2020 was adopted as the active nutrition intervention. Chemotherapy-related toxic adverse reactions and the degree of toxicity were recorded with the adoption of the Common Terminology Criteria for Adverse Events version 4.0 by the National Institutes of Health. The type of toxicity Chemotherapy-Induced Nauseaand Vomiting(CINV) and hematological.

Results

Fifty cases were enrolled in the study, and 38 cases completed the dynamic follow-ups. The average follow-up time was 125.63 d. In the context of active nutrition intervention, the prevalence of sarcopenia decreased from 26.3% before chemotherapy to 21.1% after chemotherapy. The average L3SMI decreased from 38.77 cm2/m2 to 38.04 cm2/m2, with a reduction of 1.41% ± 8.49% (P = 0.177). The SMI remained stable or increased in 57.9% (22/38) of patients. The benefit of active nutrition intervention was greater in the sarcopenic group than in the non-sarcopenic group (P = 0.033). There was an increased incidence of chemotherapy-related toxic adverse reactions of ≥ grade 3 during chemotherapy in the sarcopenic group compared with the muscle retention/gain group (P = 0.089).

Conclusion

Active nutrition intervention might decrease the degree of reduction of L3SMI and the incidence of sarcopenia in patients with gastrointestinal tumors and raise the proportion of patients with stable or increased SMI during chemotherapy.

The effectiveness of telephone and Internet-based supportive care for patients with esophageal cancer on enhanced recovery after surgery in China: A randomized controlled trial

Objective

The aim of this study was to establish a nurse-led supportive care program based on telephone and Internet support and evaluate its efficacy in comparison with conventional care on enhanced recovery after surgery.

Methods

The study was designed as an open-label, randomized controlled trial to value the efficacy of a nurse-led supportive care program in comparison with conventional care. A convenience sampling method was employed to recruit patients with esophageal cancer in a tertiary Grade A cancer center in Beijing from November 2018 to January 2019. Patients were assigned randomly (1:1) to one of the two groups (intervention group vs control group) via a web randomization system. The control group received conventional care. Patients from the intervention group received conventional care and one-on-one phone calls from nurses following their discharge assessments and education about nutrition and symptoms. Nurses also set up a WeChat group, which they invited patients to join in before discharge for better communication during follow-up. Statistical testing, including nutritional status, quality of life, the helpfulness of the follow-up service, and the patients’ satisfaction with their care, was conducted 6 months after discharge to assess for differences between the two groups. The independent sample t, chi-squared, and Mann–Whitney tests were used to compare between the experiences of the intervention and control groups. The Spearman correlation analysis was used for the analysis of correlation of the nutritional index and quality of life.

Results

Finally, 168 patients were included in the study, with 86 patients in the intervention group and 82 in the control group. Significant differences between the intervention and control groups were found in the nutrition risk screening 2002 and simple diet self-assessment tool scores. The changes in blood albumin, prealbumin, and transferrin were also statistically significant. All (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire) QLQ-C30 results of the intervention group were better than those of the control group. A significant positive correlation of the simple diet self-assessment tool (the higher, the better) and the scores for total health/quality of life were detected (r ​= ​0.214, P ​= ​0.005). A significant negative correlation of the nutrition risk screening 2002 (the lower, the better) and the scores of total health/quality of life was detected (r ​= ​−0.446, P ​= ​0.000). The patients’ scores on the helpfulness of the follow-up service and their satisfaction with it were both significantly higher in the intervention group than in the control group.

Conclusions

This study highlighted the important role of nurse-led supportive care based on telephone and Internet-based support for patients after enhanced recovery after surgery. The supportive care improved patients’ nutritional status, elevated their quality of life, and improved their satisfaction with the care provided to them.

The effect of navigation programme on the management of symptoms related to head and neck radiotherapy

BACKGROUND

This study aims to determine the effect of navigation programme in the management of symptoms related to head and neck cancer (HNC) radiotherapy.

METHODS

This randomized, controlled and experimental study was conducted between November 2018 and March 2020 with the participation of 88 patients with HNC receiving radiotherapy. Referring to the pre-prepared randomization checklist, 41 people were randomized to the experimental group and 47 to the control group. While the standard treatment approaches of the hospital were applied to all patients, the patients in the experimental group were applied an additional nursing navigation program. At the beginning of the navigation program, the patients were given a 30-minute visual training on the first day of radiotherapy and a handbook related to the expected adverse effects. Throughout subsequent seven weeks, the patient continued to be followed up via phone reminders, providing daily counseling and a weekly follow-up. Patient identification form, CTCAE v5.0 toxicity criteria and EORTC QLQ-30, H&N35 assessment questionnaires were used in the study. The first result was the difference observed in quality of life scores at the beginning, middle and end of radiotherapy.

RESULTS

Data obtained from the study revealed that the quality of life scores (p < 0.05) improved while the navigation program reduced the severity of symptoms such as mucositis, dysphagia, oral pain and weight loss (p < 0.05).

CONCLUSION

It was concluded that navigation programme is an effective approach for patients receiving head and neck radiotherapy.

TRIAL REGISTRATION

NCT04857749.