Nutrition and cancer 2 MON-P085 NUTRITIONAL CHANGES IN PATIENTS WITH LOCALLY ADVANCED HEAD AND NECK CANCER DURING TREATMENT L. Arribas1,2,3 *, L. Hurtós4, M. Taberna2,3,5,6, I. Peiró4, E. Vilajosana2,5, A. Lozano2,7, R. Mesia2,5, N. Virgili8. 1Clinical Nutrition Unit, Catalan Institute of Oncology (ICO), IDIBELL, L’Hospitalet de Llobregat, Barcelona, 2Head and Neck Unit, Bellvitge University Hospital-, Catalan Institute of Oncology (ICO), L’Hospitalet de Llobregat, Barcelona, 3University of Barcelona, Barcelona, 4Clinical Nutrition Unit, 5Medical Oncology Department, 6Cancer Epidemiology Research Program, 7Radiation Oncology Department, Catalan Institute of Oncology (ICO), IDIBELL, 8Nutrition and Dietetics Unit, Nutrition and Endocrinology Department, Bellvitge University Hospital, L’Hospitalet de Llobregat, Barcelona, Spain Rationale: The purpose of the study is to evaluate changes in body composition and nutritional status that occur throughout the oncological treatment. Methods: A prospective cohort observational study in patients diagnosed with head and neck squamous cell carcinoma (HNSCC) that underwent treatment with induction chemotherapy (iCT) followed by chemoradiotherapy or bioradiotherapy were invited to participate. All patients had dietetic counseling from the diagnosis and a close monitoring throughout the treatment implementing nutritional support as needed. Results: From June 2011 until October 2012, 20 patients were included. Nutritional and anthropometric parameters were collected at diagnosis, post iCT, after RT, 1 and 3 months post radiotherapy. According to Patient Generated Subjective Global Assessment, 30% were malnourished at diagnosis. After iCT there was an increase in weight, body mass index (BMI) and fat free mass (FFM) with almost complete improvement in dysphagia and odynophagia. Nevertheless a significant nutritional deterioration ( p = 0.0022) occurred at the end of radiotherapy with 95% of patients becoming severe or moderate malnourished. Nutritional parameters such as weight, BMI and hand grip strength also decrease significantly during treatment. Conclusion: Despite an intensive nutritional support from the diagnosis throughout the oncological treatment in advanced HNSCC cancer patients, nutritional status deteriorates during RT. Our findings suggest that iCT may help improve nutritional status by ameliorating the symptoms that limit the oral intake. This improvement in the nutritional status could contribute to minimize further deterioration. Further investigations are needed involving novel approaches to avoid nutritional deterioration. Disclosure of Interest: None declared.
MON-P086 RISK OF MUCOSITIS IN HDT PRIOR TO STEM CELL TRANSPLANTATION L. Drustrup1, M. Holst2 *. 1Department of Clinical Medicine, Aalborg University, 2Center for Nutrition and Bowel Disease, Aalborg University Hospital, Aalborg, Denmark Rationale: Mucositis is one of the most significant side effects reported in patients receiving high-dose chemotherapy (HDT) prior to stem cell transplantation due to hematology disease. Mucositis induces pain, diarrhea and reduced food intake in
S211 different degrees. This study investigated incidence of mucositis, nutritional risk (NRS) and artificial nutritional therapy. Methods: A retrospective observational cohort included all adult patients treated with HDT prior to stem cell transplantation due to lymphoma or multiple myeloma at Aalborg University Hospital during 20 months. Data was extracted from patient records, and followed patients during the 21-day treatment. Statistics: Comparisons; student’s t-test, MannWhitney, or X 2 test. Environmental risk factors by Cox proportional hazards. Results: A high incidence of mucositis was seen, with highest occurrence in the BEAM population ( p = 0.02). The prevalence of nutritional risk increased during treatment in both groups ( p = 0.47), and 41% were treated with EN or PN. An elevation of sodium ( p = 0.00) as well as potassium (K) ( p = 0.02) before upstart of treatment, increased duration of mucositis and elevation of sodium (Na) (=0.03) decrease in time to mucositis.
N= (%Female) Mucositis N(%) Yes NRS risk prior to treatment N(%) NRS risk during treatment N(%)
All HDT population
BEAM cohort
Melphalan cohort
66(35) 48(73) 32(48)
23(43) 21(91) 9(39)
43(30) 27(63) 23(47)
61(92)
22(96%)
39(91%)
Conclusion: Mucositis and nutritional risk is common in HDT, with high prevalence of need for EN/PN. Attention should be given to prevention and timing of nutritional therapy, as well as studies looking into K and Na. Disclosure of Interest: None declared.
MON-P087 HIGH-RADIODENSITY SKELETAL INDEX AS PREDICTOR OF EARLY MORTALITY IN OVARIAN ADENOCARCINOMA K. D. A. Bruno1, N. S. de Paula1, M. A. Aredes1, G. V. Chaves1 *. 1 Nutrition and Dietetics, Brazilian National Cancer Institute – INCA, Rio de Janeiro, Brazil Rationale: This study aimed to determine the prognostic value of the quantitative and qualitative parameters of the skeletal muscle (SM) in patients with ovarian adenocarcinoma. Methods: In a retrospective cohort, we included patients with ovarian adenocarcinoma, enrolled between 2008 and 2015, who had a CT scan (CT) available within 45 days before any cancer treatment. Sociodemographic and clinical data were collected, as well as one-year survival. CT images at the third lumbar vertebra (L3) were used to assess overall skeletal muscle index (SMI) using the standard range −29 to +150 Hounsfield Units (HU), which was afterwards divided into subranges of radiation attenuation: low-radiodensity skeletal muscle index (LRSMI, in the range −29 to + 29 HU) representing SM area with increased intramyocellular triglycerides, and the high-radiodensity skeletal muscle index (HRSMI, in the range +30 to +150 HU), representing the area with low fat infiltration. Sarcopenia was defined when SMI was ≤38.9 cm2/m2. KaplanMeier method and Cox Regression evaluated one-year survival. All statistical analysis were considered statistically significant when p < 0.05.