PD770 - DIAGNOSTIC DELAY AND TREATMENT TOXICITY AS DRIVERS OF NUTRITIONAL RISK IN PEDIATRIC NEPHROBLASTOMA

PD770

DIAGNOSTIC DELAY AND TREATMENT TOXICITY AS DRIVERS OF NUTRITIONAL RISK IN PEDIATRIC NEPHROBLASTOMA

N. Benider^1,*, A. Kadiri¹, I. Hassnaoui¹, K. Nouni¹, A. Lachgar¹, H. El Kacemi¹, T. Kebdani¹, K. El Hassouni¹

¹National Institute of oncology, Rabat, Morocco

Rationale: Nutritional impairment is common in pediatric oncology, but often under-estimated. In nephroblastoma both delayed diagnosis and treatment related toxicities may contribute to early and cumulative nutritional deterioration. 

Methods: We conducted a retrospective study of 24 children treated for nephroblastola over 6 years. Clinical presentation, diagnostic delay, and treatment-related toxicities were analyzed as determinants of nutritional risk.

Results: Most patients (87%) were symtomatic at diagnosis frequently representing with abdominal mass (58%) and altered general condition (54%) characterized by clinically reported weight loss, anorexia, and reduced appetite. For all those altered patients, a diagnostic delay was observed >3 months likely contributing to early nutritional impairment.

During preoperative chemotherapy, only one case of mucosis and dysphagia was reported, negatively impacting oral intake. 

Post-operative chemotherapy was associated with complications in70% of patients, including oral mucositis, diarrhea, and vomiting leading to reduced oral intake. Hematological toxicities were also frequent, including neutropenia (37%), fébrile neutropenia(21%), infections (12%) and anemia which increase metabolic demands while limiting intake. 

During Adjuvant radiotherapy, 54% of patients experienced early digestive toxicities such as abdominal pain, nausea and vomiting, diarrhea, and fever impacting significantly nutritional intake. Only one case of radiation-induced proctitis was reported. 

Overall, these findings highligt a cumulative effect of disease burden and treatment-related toxicities, progressively worsening nutritional status throughout the treatment course. 

Conclusion: Nutritional deterioration in pediatric nephroblastoma is not a single event, but the result of cumulative events. Early structured nutritional intervention should therfore be considered. 

Disclosure of Interest: None declared