Does nutrition influence quality of life in cancer patients undergoing radiotherapy?
OBJECTIVE
To investigate in cancer patients referred for radiotherapy (RT): (1) quality of life (QoL), nutritional status and nutrient intake, at the onset and at the end of RT; (2) whether individualised nutritional counselling, despite symptoms, was able to enhance nutrient intake over time and whether the latter influenced the patient's QoL; and (3) which symptoms may anticipate poorer QoL and/or reduced nutritional intake.


METHODS
One hundred and twenty-five patients with tumours of the head-neck/gastrointestinal tract (high-risk: HR), prostate, breast, lung, brain, gallbladder, uterus (low-risk: LR) were evaluated before and at the end of RT. Nutritional status was evaluated by Ottery's Subjective Global Assessment, nutritional intake by a 24-h recall food questionnaire and QoL by two instruments: EUROQOL and the European Organisation for the Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ)-C30.


RESULTS
Baseline malnutrition was prevalent in HR vs. LR (P=0.02); nutritional intake was associated with nutritional status (P=0.007); the latter did not change significantly during RT. In LR, baseline energy intake was higher than EER (P=0.001), and higher than HR' intake (P=0.002); the latter increased (P<0.03), in spite of symptom increase anew and/or in severity (P=0.0001). According to both instruments, QoL was always better in LR vs. HR (P=0.01); at the end of RT, QoL improvement in HR was correlated with increased nutritional intake (P=0.001), both remained stable in LR.


CONCLUSIONS
Individualised nutritional counselling accounting for nutritional status and clinical condition, was able to improve nutritional intake and patients' QoL, despite self-reported symptoms.
Ravasco
Paula
P
Centre of Nutrition and Metabolism, Institute of Molecular Medicine of the Faculty of Medicine of the University of Lisbon, Lisbon, Portugal.
Monteiro-Grillo
Isabel
I
Camilo
Maria Ermelinda
ME
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D037001:Directive Counseling; D004435:Eating / Q000523:psychology / Q000528:radiation effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000178:diet therapy* / Q000523:psychology / Q000532:radiotherapy*; D015596:Nutrition Assessment; D009752:Nutritional Status; D011788:Quality of Life