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Nutrition impact symptom monitoring and weight loss outcomes: a longitudinal radiotherapy study
  1. Amaia Urrizola1,2,
  2. Olav Dajani1,2,
  3. Nina Aass1,2,3,
  4. Ellen Bjerkeset1,2,
  5. Marianne Jensen Hjermstad1,2,
  6. Stein Kaasa1,2,3,
  7. Pål Klepstad4,
  8. Aleksandra Pirnat1,2,
  9. Ida Raaness5,
  10. Hanne Steinsheim1,2 and
  11. Asta Bye1,2,6
  1. 1Department of Oncology, Oslo University Hospital, Oslo, Norway
  2. 2European Palliative Care Research Center, University of Oslo, Oslo, Norway
  3. 3Institute of Clinical Medicine, University of Oslo, Oslo, Norway
  4. 4Department of Intensive Care Medicine, St Olav University Hospital, Trondheim, Norway
  5. 5Department of Clinical Medicine, University of Bergen, Faculty of Medicine and Dentistry, Bergen, Norway
  6. 6Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
  1. Correspondence to Dr Amaia Urrizola, Oslo University Hospital, Oslo, Norway; amaurr{at}ous-hf.no

Abstract

Objectives Nutrition impact symptoms (NIS) are associated with weight loss (WL), and decreased energy intake in cross-sectional studies. We aimed to ascertain associations between changes in NIS burden, energy intake and WL over time in patients with advanced cancer.

Methods Adult patients from an observational radiotherapy study for painful bone metastases self-reported NIS and WL using the Patient-Generated Subjective Global Assessment tool (PG-SGA) at baseline and week eight (W8). NIS burden, the sum of NIS per patient, categorised as 0, 1–2 and ≥3 with changes defined as 2-point differences from baseline to W8 were used. Energy intake was assessed by 24-hour recall interviews.

Results 111 patients (72.1%) were analysed and grouped by NIS burden; 0 NIS (44.1%), 1–2 NIS (30.6%) and ≥3 NIS (25.2%). Patients with NIS burden of ≥3 reported higher baseline WL compared with those with 1–2 or 0 NIS (46.4% vs 18.2% vs 10.2%, respectively, p=0.002). At W8, 21 patients (19%) reported improved NIS burden, accompanied by a lower proportion of severe (≥5%) new-onset WL (19% vs 42.1%) and higher energy intake (median 29.6 vs 21.2 kcal/kg) than those with worsened NIS burden (17.1%).

Conclusions NIS management may improve energy intake and prevent WL, emphasising the importance of systematic follow-up and interventions.

ClinicalTrials.gov registration NCT02107664

  • Symptoms and symptom management
  • Clinical assessment
  • Cancer
  • Palliative Care
  • Supportive care

https://doi.org/10.1136/spcare-2024-004939

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    Footnotes

    • Contributors AB and MJH were involved in planning the study, analysed and interpreted the data and were major contributors in the writing process. AU analysed and interpreted the data and was a major contributor in the writing process. EB and HS collected the data. ODs, IR and AP were involved in data analysis and interpretation and contributed towards the writing process. SK, NA and PK were involved in the planning of the study and contributed towards the writing process. All authors reviewed and approved the final article.

    • Funding This work was supported by a non-restricted grant from the Norwegian Cancer Society (NCS) and a Ph.D scholarship from the Liaison Committee for Education, Research and Innovation in Central Norway.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.