Anecdotally many HPV+OPX patients experience ongoing weight loss and a delay in functional oral recovery in the four months post CRT whilst awaiting review PET scan. This audit aimed to give a clearer understanding of the challenges of this phase of recovery.
Weights were recorded at pre-treatment (SIM), during treatment, at follow up and at time of PET scan. At PET, we also recorded: Enteral feeding; Oral Nutritional Supplement (ONS) use; Xerostomia; Dysgeusia; Secretions.
Of 51 HPV+OPX patients treated, 27 had complete data for the weight audit. Only 1 patient maintained weight during and post CRT. 96% (n=26) lost weight from SIM to end of RT with 30% (n=8) experiencing >10% weight loss. 92% (n=25) had further weight loss post CRT, of which 55% (n=15) losing a further 5-10% weight and 15% (n=4) losing a further 10-15% weight. By PET, 37% (n=10) were at their lowest ever recorded weight, however 56% (n=15) had regained some weight, notably a median gain of 1.8kg.
36 patients fulfilled criteria for nutritional impact symptom audit. By time of PET scan 8% (n=3) remained reliant on enteral feeding; 31% (n=11) remained on ONS. 81% (n=29) had ongoing xerostomia; 55% (n=20) had ongoing dysgeusia; 8% (n=3) had ongoing abnormal secretions.
This data demonstrates the stark ongoing weight loss and symptoms that occur during the initial post CRT recovery phase. Dietitians may need to consider adapting clinical practice to review this group more frequently and intervene with escalated nutritional care plans including earlier nutrition support.
Aisling Nolan1
1 Department of Nutrition & Dietetics, St. Luke’s Oncology Radiation Network, Dublin