Effect of Oral Nutritional Support During Radiation Therapy in Patients with Thoracic and Gead/Neck Cancer

Chun, Mi Sun; Kang, Seung Hee; Kwon, Hye Kyung; Oh, Young Taek; Kim, Joo Ri; Lee, Hyun Joo; Lee, Soon Young; Choi, Sun Jeong

Abstract

PURPOSE
This study was designed to evaluate the role of oral nutritional support and nutritional counseling by dietician during radiation therapy.
MATERIALS AND METHODS
This study included total 58 patients with head/neck, lung, or esophageal cancers who received radiation therapy with radical purpose between February and December, 1996. They were randomized either into nutrient supplement group (Group I) or control group (Group II). In Group I, the dietician advised patients to take high density nutrient supplement (NuCare, 250 kcal/can, Miwon co., LTD) based on dieticians initial evaluation for oral intake from initiation to completion of radiation therapy. In Group II, patients received nutritional support other than high density nutrient supplement only when patients lose weight more than 2 Kg during radiation treatment. All patients were evaluated for nutritional status and diet pattern and received nutritional counseling before radiation therapy and then weekly during treatment.
RESULTS
Total 45 patients (22 patients in group I, 23 patients in group II) were available. In group I, all patients received average 3 cans (2~4 cans) a day. The calory from nutrient supplement was 43.9% of their daily energy intake (25.9~68.7%). About 72.7% of patients in Group I could keep up with their oral intake over 80% of daily requirement energy comparing to only 12.3% for patients in Group II(p<0.05). The patients in Group I started to lose weight 2 weeks later and lost weight more than 3 Kg less often than patients in Group II (5/22 vs 8/23, p>0.05).
CONCLUSION
There was less significant weight loss in patients who started oral nutritional supplement based on the daily requirement energy early in radiation therapy. We think it is better to recommend nutritional supplement before weight loss started because radiation induced side effects such as esophagitis and oral mucositis prohibited patients to continue to take nutrient supplement.