LB001 - A REGRESSION-BASED APPROACH REVEALS SYMPTOMS AND CLINICAL FEATURES ASSOCIATED WITH IMPAIRED ENERGY INTAKE IN PATIENTS WITH HNC TREATED WITH RADICAL INTENT RADIOTHERAPY

LB001

A REGRESSION-BASED APPROACH REVEALS SYMPTOMS AND CLINICAL FEATURES ASSOCIATED WITH IMPAIRED ENERGY INTAKE IN PATIENTS WITH HNC TREATED WITH RADICAL INTENT RADIOTHERAPY

A. Burgos^1,*, W. Wismer¹, V. Mazurak¹, V. Baracos²

¹Agricultural, Food and Nutritional Science (AFNS), ²Oncology, University of Alberta, Edmonton, Canada

Rationale: Reduced dietary intake results in insufficient energy intake among head and neck cancer (HNC) patients during treatment. The relative contribution of nutrition impact symptoms (NIS) and patient clinical features on impaired energy intake is unknown.

Methods: Clinical features were collected from medical records. Longitudinal data were collected from HNC patients (n=41) undergoing treatment with radical intent radiation (RT) (30 fractions over 6 w). One-day prospective dietary records were collected weekly for 7 weeks, and energy intake (kcal/kg BW/d) was calculated (Food Processor© software, Canadian Nutrient Database). Seventeen NIS were assessed weekly on the HNC Symptom Checklist© (PMID 22588710) (1= not at all;5 = a lot) and re-categorized as mild (1-3) or severe (4-5). Multivariate logistic regression analysis tested for associations among the variables and energy intake.

Results:  Univariate regressions identified that treatment, baseline BMI, pain, depression and loss of appetite negatively impacted energy intake; other symptoms did not significantly associate with energy intake.  In the multivariate linear mixed-effects models controlled for cancer treatment (RT, surgery, chemo), decreased kcal/kg BW/d was observed during radiation, peaking at week 6 (β= −5.37, p=0.019). Higher BMI (kg/m²) was associated with lower kcal/kg BW/d (β= −1.022, p<0.001). Compared with mild symptoms, severe depression or pain were associated with lower kcal/kg BW/d (β= −6.70, p=0.025), (β= −3.17, p=0.034) respectively, while loss of appetite showed a trend (β = −2.75, p=0.069).

Conclusion: Of the NIS, severe depression, and severe pain had the greatest negative impact on energy intake among HNC patients during treatment. Medical management of these symptoms would be a priority to enable food intake.

References: Schmidt et al. Support Care Cancer. 2013;21:27–34.

Disclosure of Interest: A. Burgos Grant / Research Support from: The authors declare that they have no personal or financial conflicts of interest related to this work., W. Wismer Grant / Research Support from: The authors declare that they have no personal or financial conflicts of interest related to this work., V. Mazurak Grant / Research Support from: The authors declare that they have no personal or financial conflicts of interest related to this work., V. Baracos Grant / Research Support from: The authors declare that they have no personal or financial conflicts of interest related to this work.