Evaluati̇on of nutritional situation in pediatric oncology patients

Malnutrition is a common problem in pediatric oncology patients. Patients can experience it at time of diagnosis or during cancer treatment. Since treatment is more difficult after a child becomes malnourished. Patients should be carefully evaluated and monitored from the time of diagnosis. There are studies in the literature on the assessment of nutritional status in these patients. The aim of this study was to evaluate the nutritional status of pediatric oncology patients at diagnosis and during treatment with anthropometric measurements. In our study, the nutritional status of 43 pediatric cancer patients aged 1-17 years who applied to Bursa Uludag University Faculty of Medicine Pediatric Oncology Polyclinic between February 1, 2018 and July 31, 2018 were evaluated by anthropometric measurements at the time of diagnosis and during the 6 month treatment period. Body weight, height, mid arm circumference and subscapular, triceps skinfold thickness measurements were performed at the time of diagnosis (0. month) and monthly for 6 months. Body weight z score, height z score, mid arm circumference z score, subscapular and triceps skinfold thickness z scores, weight for height (WFH) and body mass index values (BMI) have been calculated. Demographic, clinical features and treatment applications of the patients included in the study were recorded. Of the 43 patients included in the study, 26 were male (60,5%) and 17 were female (39,5%). Eleven of the patients in the study had brain tumors (25,6%), 7 of them had bone and other soft tissue sarcomas (16,3%), 6 of them had neuroblastomas (14%), 5 of them had non-Hodgkin lymphoma (11,6%), 4 of them had Hodgkin lymphoma (9,3%), 3 of them had Wilms tumor (7%), 3 of them had hepatoblastoma (7%) and 1 had nasopharyngeal carcinoma, renal carcinoma, nut carcinoma, endodermal sinus tumor (9,3%). Malnutrition rates were determined as 39,5% and 45% at the time of diagnosis and at the 6th month according to anthropometric measurements. When the anthropometric measurements were examined monthly according to the diagnostic groups, high levels of deterioration in nutritional parameters were detected especially in patients with brain tumor and sarcoma. The z scores of anthropometric measurements were compared between the diagnostic groups, but statistically no significant difference was found. The decrease in body mass index was higher in patients who did not receive total parenteral nutrition (TPN) support than those who received TPN support during the six month follow-up (p=0,04). In patients with brain tumors, it was found that the delay in chemotherapy time was longer than in patients with lymphoma due to intervening neutropenic sepsis attacks (p=0,03). In conclusion, malnutrition should be recognized early in pediatric oncology cases and more importantly, prevented with the necessary nutritional support. In our study, it was observed that there was no difference between skin thickness measurements and height, weight, BMI values in terms of nutritional status. Early nutritional support is recommended especially in patients with brain tumor and sarcoma. Malnutrition should be recognized and prevented in the early period in cancer patients by studies with larger number of patients. Keywords: Cancer, children, malnutrition, anthropometric measurements