ESTRO 2024 - Abstract Book

S1683

Clinical - Lung

ESTRO 2024

Purpose/Objective:

Malnutrition is common in patients with lung cancer and is associated with negative prognosis [1-3]. Poor nutritional status, resulting from the disease and its treatment, is also linked to reduced quality of life [4].

Despite the high prevalence of malnutrition observed in this patient group, the role of the specialist dietitian is less established in lung cancer treatment pathways when compared to other cancer sites (e.g. head and neck (H&N) and upper gastrointestinal (GI) cancers). European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines recommend that ‘during radiotherapy (with special attention to radiotherapy to the H&N, thorax and GI tract) an adequate nutritional intake should be ensured primarily by individualised nutritional counselling and/ or with use of oral nutritional supplements (ONS), in order to avoid nutritional deterioration, maintain intake and avoid radiotherapy interruptions’ [5].

Nutritional screening and routine dietetic review are not included in standard care provision for patients receiving radical radiotherapy (RT) for lung cancer at Leeds Cancer Centre (one of the largest cancer centres in the UK).

The Yorkshire Cancer Research funded Prehabilitation Radiotherapy Exercise smoking Habit cessation And Balanced diet Study (PREHABS) was designed to determine if it is feasible to embed interventions promoting a healthier lifestyle (including routine specialist dietetic intervention) into the radical lung RT pathway.

Material/Methods:

Ethical and regulatory approvals for PREHABS were obtained in September 2021.

Two PREHABS therapeutic radiographers screened and consented study participants and delivered the exercise and smoking cessation interventions.

Patients recruited to the dietary intervention arm of PREHABS received individualised dietary assessment and counselling from the PREHABS dietitian at weekly dietetic reviews during RT.

Body weight, Body Mass Index (BMI) and percentage weight change were recorded before, during (weekly) and after RT (during a 12-month follow-up period). Additional anthropometric measures (Handgrip and mid-upper arm circumference) were measured by the dietitian during RT. Data were collected on the requirement for ONS, the incidence and duration of enteral feeding, the incidence of nutrition-related hospital admissions and the necessity for dietetic follow-up post completion of RT.

In depth semi-structured interviews were performed with 7 patients who took part in PREHABS.

Both quantitative and qualitative data will be used to assess the dietetic intervention efficacy following the study end date of 31/10/2023.

Results:

61 patients were recruited to PREHABS between September 2021 and October 2022 of which 53 (87%) patients consented to dietary intervention.