Nutritional assessment and intervention in a pediatric oncology unit

Schoeman, Judy

doi:10.4103/0019-509x.175832

Cited by 22 publications

(36 citation statements)

References 3 publications

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“…Assessment of nutritional status based on weight is deceptive and can be affected by tumor mass, edema, ascites, and the weight-gaining effects of steroid therapy in children with leukemias/lymphomas. 20 Therefore, the MUAC increment in our study is more relevant clinically than the insignificant weight gain. Further, all children with appropriate WFH/BMI and MUAC at baseline maintained their eutrophic status at the end of the study in the study arm.…”

Section: Discussionmentioning

confidence: 65%

“…One of the reasons for this disparity is that a greater proportion of patients had a suboptimal MUAC at baseline (56%), in comparison to merely 20% of patients who were wasted based on weight‐based anthropometry. Assessment of nutritional status based on weight is deceptive and can be affected by tumor mass, edema, ascites, and the weight‐gaining effects of steroid therapy in children with leukemias/lymphomas . Therefore, the MUAC increment in our study is more relevant clinically than the insignificant weight gain.…”

Section: Discussionmentioning

confidence: 99%

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Validation of an algorithmic nutritional approach in children undergoing chemotherapy for cancer

Totadri

Trehan

Mahajan

et al. 2019

Pediatric Blood & Cancer

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Background Undernutrition impacts clinical outcome adversely in children with cancer. This study aimed to validate a nutritional algorithm with specific application to the low‐ and middle‐income country (LMIC) setting. Procedure Fifty children with a new diagnosis of cancer were enrolled in this randomized interventional study. Weight, height/length, and mid‐upper‐arm circumference (MUAC) were measured at baseline. The study arm was administered nutritional care as per the algorithm and the control arm received the institutional standard of care. Weight was monitored regularly and MUAC was repeated after 3 months. Children were classified based on weight for height if <2 years of age or body mass index if ≥2 years, as normal, wasted, and severely wasted. The algorithmic approach comprised administration of oral supplements, nasogastric feeds, and/or parenteral nutrition based on objective assessment of the nutritional status. Results Fifty patients were analyzed (study: 25, control: 25). Four in the study arm (16%) and six in the control arm (24%) had wasting at baseline. MUAC was <5th percentile in 15 (60%) and 13 (52%) patients in the study and control arms, respectively. At the end of 3 months, the median increment in weight was 0.8 kg (interquartile range [IQR]: –0.02; 2.00) and 0.0 kg (IQR: –0.70; 1.25) in the study and control arms, respectively (P = .153). The median increment in MUAC was 1.20 cm (IQR: 0.10; 2.30) and 0.00 cm (IQR: –0.50; 1.10) in the study and control arms, respectively (P = .020). Conclusions The application of an algorithm designed for use in LMICs resulted in significant improvement in nutritional status, as measured by MUAC.

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Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Validation of an algorithmic nutritional approach in children undergoing chemotherapy for cancer

Totadri

Trehan

Mahajan

et al. 2019

Pediatric Blood & Cancer

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“…Malnutrition is widespread among children living in Africa with approximately 46% of children diagnosed with cancer also being diagnosed with malnutrition [8]. Managing malnutrition can be challenging for paediatric cancer units (PCUs) with limited resources [9]; however, the clinical implications of not remediating malnutrition leads to reduced survival and increased treatment-related toxicities [10].…”

Section: Nutrition Workhopmentioning

confidence: 99%

Highlights from the 13th African Continental Meeting of the International Society of Paediatric Oncology (SIOP), 6–9 March 2019, Cairo, Egypt

Khalek

Afungchwi

Beltagy

et al. 2019

ecancer

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The 13th African continental meeting of the international society of paediatric oncology, held on 6–9 March 2019 in Cairo, was organised in collaboration with the Children Cancer Hospital (57357) in Egypt and the global parents’ organisation (Childhood Cancer International) and supported by a large international faculty. With 629 delegates from 37 countries (24 African), this was the largest forum of healthcare professionals focused on children and young people with cancer in Africa to showcase advances and discuss further improvements. Three targeted workshops, on nursing care, pharmacy and nutrition, attracted large numbers and catalysed new collaborative initiatives in supportive care studies, extended roles for pharmacists in quality control and care delivery and addressed malnutrition concurrently with cancer treatment. The Collaborative Wilms Tumour Africa Project, open in seven sub-Saharan countries, and the trials in Burkitt’s lymphoma reported encouraging outcomes with further initiatives in supportive care (the supportive care for children with cancer in Africa project). While acknowledging deficits in radiotherapy provision, available in only 23 of 52 African countries, centres with facilities reported their technical advances that benefit patients. Of great importance for children with brain tumours, who are underdiagnosed in Africa, was the first announcement of African paediatric neuro-oncology society, whose 63 current members aim to tackle the shortage of neurosurgeons through training fellowships, workshops and a dedicated conference. The congress provided the opportunity to discuss how African countries will work with the WHO global initiative aiming to improve childhood cancer survival to 60% in all countries by 2030. This conference report is dedicated to the three Kenyan delegates who died tragically on the Ethiopian Airlines flight ET302 on their way home, full of new ideas and pride in what they had achieved so far. All those who heard their presentations are determined to continue their excellent work to improve cancer care for children in Africa.

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“…It has been long ascertained that the nutritional status in case of chronic wasting diseases, especially in case of childhood cancer, does influence the outcome of the disease, the course of the therapy, including treatment tolerance and infection risk, not to mention the quality of life and the cost of care [5,6]. It is also known that the tumour itself means a risk for malnutrition, especially in case of children.…”

Section: Introductionmentioning

confidence: 99%

Different nutritional screening tools and recommended screening algorithm for pediatric oncology patients

et al. 2021

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Background & aims: Cancer is one of the leading causes of death for children; however, appropriate nutritional status can positively affect disease progression and outcome. The aim of this study was to present our self-developed nutritional risk screening method, relate it to another validated tool and to objective bio-impedance measures. We intended to recommend a screening algorithm which can be used in our pediatric oncology facilities. Methods: We analysed data from 109 pediatric oncology patients (age 3e18) at the 2nd Department of Pediatrics, Semmelweis University between 2017 and 2018. The nutritional status was assessed by the Nutrition screening tool for childhood cancer (SCAN), Nutrition risk screening for pediatric cancer (NRS-PC) our own self-developed screening tool and Bio-impedance analysis (InBody 720 and S10). Classifier properties for low muscle mass measured by Bio-impedance analysis were compared for SCAN and NRS-PC in the overall sample and in the different phases of the disease. Results: The AUC of 0.67 [95% CI:0.58,0.75] of the SCAN was significantly lower (Z ¼ À2.46, p ¼ 0.014) than in the case of the NRS-PC (AUC ¼ 0.75 [95% CI:0.67,0.82]), indicating that NRS-PC has better classifier properties to identify children with lower muscle mass. No significant difference was found in the different phases of the disease. Conclusions: Based on our results, we suggest screening high BMI patients first with NRS-PC. However, in case of low BMI bio-impedance measures provide more precise information on muscle mass and nutritional risk. Further data are needed to decide whether the NRS-PC is sensitive enough in normal BMI patients.

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Nutritional assessment and intervention in a pediatric oncology unit

Cited by 22 publications

References 3 publications

Validation of an algorithmic nutritional approach in children undergoing chemotherapy for cancer

Validation of an algorithmic nutritional approach in children undergoing chemotherapy for cancer

Highlights from the 13th African Continental Meeting of the International Society of Paediatric Oncology (SIOP), 6–9 March 2019, Cairo, Egypt

Different nutritional screening tools and recommended screening algorithm for pediatric oncology patients

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