A single-center retrospective study investigating use of dietetic interventions and changes in nutritional intake and weight in children receiving proton beam therapy.
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BACKGROUND: Proton beam therapy (PBT) is a novel treatment for children with certain cancers. It requires meticulous planning tailored to a child's body contour, shape, and size. Weight maintenance is essential throughout therapy to avoid unnecessary treatment replanning. Despite the specificity of PBT, gastrointestinal side effects can still occur and negatively impact children's nutritional intake. AIM: Examine the use of dietetic interventions, weight change, and calorie intake of children during PBT. METHODS: A retrospective study at a single center was undertaken. Nutritional outcomes were examined at baseline, wk-1, wk-3, wk-6 of PBT, including changes in weight Z-score and calorie intake from oral and tube feeding routes. The impact of children's disease type on the need for tube feeding, weight change, and calorie intake was analyzed. RESULTS: One hundred and twelve children received PBT, of which 26% (29/112) did not require dietetic intervention and were excluded, but 74% (83/112) did and were included. Of these, 51% maintained their oral intake exclusively, 28% had a prophylactic gastrostomy (including 60%, 15/25 of those with head and neck cancer), 16% a prophylactic nasogastric tube (including 23%, 11/48 of those with neurological disease). From baseline to wk-6, 80% maintained their weight within 5% loss/gain. The mean weight Z-score significantly reduced from 0.22 to 0.10 (P = 0.038), as did oral calorie intake (P = 0.003). Calorie intake from tube feeding significantly increased (P = 0.006). CONCLUSIONS: Nutritional support ensured that most children maintained a stable weight during PBT. A high prevalence of children required tube feeding via a gastrostomy or nasogastric tube as their oral intake declined.