PD800 - SMALLER MARGINS, EVOLVING CHALLENGES: IDENTIFYING CHANGING DEMANDS IN NUTRITIONAL MANAGEMENT FOR HEAD AND NECK CANCER PATIENTS ALONGSIDE REFINEMENT IN RADIOTHERAPY TREATMENT MARGINS.

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PD800

SMALLER MARGINS, EVOLVING CHALLENGES: IDENTIFYING CHANGING DEMANDS IN NUTRITIONAL MANAGEMENT FOR HEAD AND NECK CANCER PATIENTS ALONGSIDE REFINEMENT IN RADIOTHERAPY TREATMENT MARGINS.

A. Eaton1,*, T. Amir2, L. Johansson1, K. Wade-McBane1

1Nutrition and Dietetics, 2Oncology, Imperial College Healthcare NHS Trust, London, United Kingdom

 

Rationale: This evaluation investigates the influence of refined radiotherapy margins for treating head and neck cancer (HNC) on nutritional outcomes. This is important as our findings may inform the evolving dietetic approach to HNC care.

Methods: This service evaluation included patients receiving primary radiotherapy for HNC. Two cohorts, treated before (2022) and after (2024–2025) novel margin refinement, were analysed.1 Retrospective data gethered from Cerner© included demographics, treatment characteristics, Functional Oral Intake Scale (FOIS) scores, and nutritional outcomes of weight change and enteral feeding tube (EFT) insertion and removal dates. The data were analysed via descriptive statistics in Excel©.

Results: Fifty-five patients were included (2022: n=25; 2024–2025: n=30). Mean EFT dwell time from end of treatment (EOT) fell from 146 to 102 days. At EOT, ‘low’ FOIS scores were more common in 2022 (92% vs 63%); at 3 months, 2022 also had more ‘low’ (40% vs 13%). Weight loss of >10% during treatment was higher in 2024–2025 (40% vs 28%). Post-treatment, fewer gained weight and more lost >10% in 2024–2025.

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Conclusion: This evaluation shows that refining radiotherapy margins for primary HNC reduces EFT dwell time and improves functional oral intake, but not weight outcomes. This underscores limited understanding of multifactorial nutritional decline among HNC radiotherapy patients, and the need for updated  nutrition guidance aligned with the evolving trajectory of recovery observed. 

References:         1. The Royal College of Radiologists, 2022. ‘Head and neck cancer RCR consensus statements.’ 

        2. Crary MA, Mann GD, Groher ME. (2005) Initial psychometric assessment of a functional oral intake scale for dysphagia in stroke patients. Arch Phys Med Rehabil

Disclosure of Interest: None declared