M Durán-Poveda1, P Jimenez-Fonseca2, M Sirvent-Ochando3, P P García-Luna4, J L Pereira-Cunill4, B Lema-Marqués5, M T Parejo-Arrondo6, C Belda-Iniesta7. 1. Department of Digestive and General Surgery, Hospital Universitario Rey Juan Carlos, Madrid, Spain. 2. Department of Medical Oncology, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain. 3. Department of Hospital Pharmacy, Hospital HLA-Vistahermosa, Alicante, Spain. 4. Department of Endocrinology and Nutrition, Hospital Universitario Virgen del Rocío, Seville, Spain. 5. Nutrition Department, Clínica Diagonal, Esplugues de Llobregat, Barcelona, Spain. 6. Oncology Nursing Department, Hospital Universitari Sant Joan de Reus, Reus, Tarragona, Spain. 7. Department of Medical Oncology, HM CIOCC, Calle Oña 10, 28050, Madrid, Spain. cbelda@hmhospitales.com.
Abstract
INTRODUCTION: Malnutrition is a common complication in cancer patients and can negatively affect the outcome of treatments. This study aimed to reach a consensus on nutritional needs and optimize nutritional care in the management of cancer patients at a national level. METHODS: A qualitative, multicenter, two-round Delphi study involving 52 specialists with experience in nutritional support in cancer patients was conducted. RESULTS: Regarding the presence of malnutrition, 57.7% of the participants stated that < 30% of the patients had malnutrition at the time of diagnosis, 40.4% considered that 31-50% had malnutrition during cancer treatment, and 26.9% that > 50% at the end of the treatment. Forty percent of participants believed that the main objective of nutritional treatment was to improve quality of life and 34.6% to improve tolerability and adherence to chemotherapy. The quality nutritional care provided at their centers was rated as medium-low by 67.3%. Enteral and parenteral nutrition was administered to less than 10% and less than 5% of patients in 40.4 and 76.9% of cases, respectively. In relation to nutritional screening at the time of diagnosis, 62.9% of participants considered than screening to assess the risk of malnutrition was performed in < 30% of patients. CONCLUSIONS: There is an important variability in the management of cancer patient nutrition, which is associated with the absence of a national consensus on nutritional support in this field. Given the incidence of nutritional disorders in cancer patients, a specialist in clinical nutrition (regardless of his/her specialty) should be integrated into the strategic cancer plan.
INTRODUCTION:Malnutrition is a common complication in cancerpatients and can negatively affect the outcome of treatments. This study aimed to reach a consensus on nutritional needs and optimize nutritional care in the management of cancerpatients at a national level. METHODS: A qualitative, multicenter, two-round Delphi study involving 52 specialists with experience in nutritional support in cancerpatients was conducted. RESULTS: Regarding the presence of malnutrition, 57.7% of the participants stated that < 30% of the patients had malnutrition at the time of diagnosis, 40.4% considered that 31-50% had malnutrition during cancer treatment, and 26.9% that > 50% at the end of the treatment. Forty percent of participants believed that the main objective of nutritional treatment was to improve quality of life and 34.6% to improve tolerability and adherence to chemotherapy. The quality nutritional care provided at their centers was rated as medium-low by 67.3%. Enteral and parenteral nutrition was administered to less than 10% and less than 5% of patients in 40.4 and 76.9% of cases, respectively. In relation to nutritional screening at the time of diagnosis, 62.9% of participants considered than screening to assess the risk of malnutrition was performed in < 30% of patients. CONCLUSIONS: There is an important variability in the management of cancerpatient nutrition, which is associated with the absence of a national consensus on nutritional support in this field. Given the incidence of nutritional disorders in cancerpatients, a specialist in clinical nutrition (regardless of his/her specialty) should be integrated into the strategic cancer plan.
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