Nutritional evolution and identification of factors associated with
nutritional depletion in children and adolescents with malignant
neoplasms submitted to radiotherapy
Abstract
Objective: To verify the evolution of the nutritional status (NS) of
children and adolescents with cancer during radiotherapy (RT) treatment
and to investigate which factors are associated with nutritional
depletion at the end of the treatment. Procedures: Historical cohort
with patients between 1 and 19 years, who underwent RT and received
nutritional monitoring throughout the treatment. Patients were evaluated
at T1 (up to 1 month before RT), T2 (2/3 months after starting RT) and
T3 (up to 1 month after RT completion). The evolution of weight,
mid-upper arm circumference [MUAC], triceps skinfold thickness
[TST], body mass index for age [BMI/A] and weight loss [WL]
were verified and considered severe when >5%. Results: A
reduction in BMI/A (p<0.001), weight (p 0.001), MUAC (p 0.001)
and TST (p 0.005), and an increase in the incidence of thinness (BMI/A
<-2) T1: 13.8% and T3: 19% and nutritional risk (BMI/A
between <-1 and >-2) - T1: 20.7% and T3: 27.6%
was observed in the general sample (n=116). Severe WL occurred in 40.7%
of the sample. Irradiation site (p<0.001), chemotherapy
[CT] (p 0.001) and CT and sedation (p 0.024) were associated with NS
of thinness at T3. However, irradiation site (p 0.006), CT (p 0.002) and
previous thinness (p 0.036) where observed for WL>5% (T1
and T3). Conclusions: The malnutrition process occurred in an expressive
and significant way, even in the presence of nutritional monitoring. The
irradiation site and concomitant chemotherapy were associated with
severe WL and thinness at the end of the treatment.