# Regular nutritional monitoring in pediatric cancer patients undergoing radiotherapy: a prospective observational pilot study

## TL;DR

This study suggests that regular nutritional monitoring during radiotherapy for pediatric cancer patients may improve treatment outcomes and quality of life.

## Contribution

The study introduces the idea that regular nutritional monitoring during radiotherapy could be integrated into treatment plans, not just supportive care.

## Key findings

- More than one-third of pediatric cancer patients were malnourished before radiotherapy.
- Weight, BMI, and MUAC declined significantly during radiotherapy, with lower caregiver support and quality of life in patients who lost weight.
- Patients without initial malnutrition had significantly better progression-free survival.

## Abstract

This pilot study aimed to explore the possible effects of regular, ongoing nutritional monitoring on dietary status, treatment results, and quality of life in pediatric cancer patients receiving radiotherapy. The study also sought to assess the potential role of caregiver nutritional support during treatment.

Anthropometric measures, including weight, height, body mass index z-score (BMI), and mid-upper arm circumference (MUAC), were recorded for 15 patients. Individual nutritional plans, the quality of caregiver-provided nutritional support, and inflammatory parameters were assessed weekly during radiotherapy. Quality of life was measured using a validated questionnaire at the beginning and end of radiotherapy.

More than one-third of patients were malnourished prior to radiotherapy. A decline was observed, especially in the fourth week of radiotherapy, for weight (p = 0.016), BMI (p = 0.013), and MUAC (p = 0.081). The albumin-to-globulin ratio (AGR) (p = 0.004) and platelet–lymphocyte ratio (PLR) (p = 0.013) peaked at the same time. Caregiver nutritional support scores (p = 0.026) and quality-of-life scores (p = 0.037) were lower in patients who experienced weight loss during radiotherapy. The median follow-up period was 13 months (range 9–16 months). Progression-free survival showed a non-significant trend in patients without weight loss [85.7% (95% CI, 42–99%) vs. 70% (95% CI, 35–93%), p = 0.590] and was significantly better in patients who began radiotherapy without malnutrition [100% (95% CI, 66–100%) vs. 50% (95% CI, 12–88%), p = 0.019].

Our initial findings suggest that regular nutritional monitoring may be a part of treatment plans, not just supportive care, for pediatric patients undergoing radiotherapy. Further research involving larger patient populations should be conducted to establish high-quality evidence on this topic.