4 research outputs found
Prognostic value of bioelectrical impedance analysis in head and neck cancer patients undergoing radiotherapy: a VALOR® study
IntroductionBioelectrical impedance analysis (BIA) serves as a method to estimate body composition. Parameters such as phase angle (PA), standardized phase angle (SPA), body mass cell (BCM), BCM index (BCMI), and fat-free mass (FFM) might significantly impact the prognosis of head and neck cancer (HNC) patients. The present study aimed to investigate whether bioelectrical parameters can be used to predict survival in the HNC population and establish the optimal cutoff points for predictive accuracy.MethodsA multicenter observational study was performed across 12 tertiary hospitals in Andalusia (a region from the south of Spain). A total of 494 patients diagnosed with HNC between 2020 and 2022 at different stages were included in this study, with a minimum follow-up period of 12 months. The BIA assessment was carried out during the first 2 weeks of radical radiotherapy treatment with chemotherapy or other systemic treatments. A multivariate logistic regression analysis of overall survival, complications, hospital admission, and palliative care and its relationship with BIA nutritional assessment was performed.ResultsSignificant prognostic factors identified in the multivariable analysis encompassed phase angle (PA), standardized phase angle (SPA), body cell mass (BCM), and BCM index (BCMI). Lower PA and BCM values were significantly associated with adverse clinical outcomes. A BCM threshold above 17 kg/m2 was the most significant predictor for predicting survival within the overall HNC population. The PA values of <5.1° in male and <4.8° in female patients showed the best predictive potential for mortality. Increased PA (as a continuous variable) demonstrated a significantly reduced risk for mortality (OR, 0.64; 95% CI, 0.43–0.94; p < 0.05) and a decreased likelihood of hospital admission (OR, 0.75; 95% CI, 0.52–1.07; p < 0.05). Higher BCM correlated with a lower risk of mortality (OR, 0.88; 95% CI, 0.80–0.96; p < 0.01) and a diminished probability of hospital admission (OR, 0.91; 95% CI, 0.83–0.99; p < 0.05).ConclusionBIA is a crucial tool in the nutritional assessment of HNC patients. BCM and PA are the main bioelectrical parameters used to predict clinical outcomes in this population. Future studies are needed to validate BIA variables in a large cohort to ensure whether early intensification of nutritional treatment would improve survival
Analysis of nutritional interventions in the care process of oncological patients in Andalusia — The NOA project
IntroducciĂłn: la desnutriciĂłn en los pacientes oncolĂłgicos puede conllevar una reducciĂłn de la calidad de vida del paciente y un aumento de
la morbimortalidad y de los costes sanitarios asociados.
Objetivos: analizar las intervenciones nutricionales en las diferentes fases del proceso oncolĂłgico, integrando las necesidades de los pacientes
y las de los profesionales sanitarios.
Material y métodos: se utilizaron técnicas de Design Thinking para abordar el análisis de la situación actual e identificar los aspectos clave.
Participaron 13 profesionales de 8 centros sanitarios (endocrinologĂa y nutriciĂłn, oncologĂa mĂ©dica y radioterápica, atenciĂłn primaria (AP),
enfermerĂa y dietĂ©tica) pĂşblicos de AndalucĂa.
Resultados: no se realiza cribado nutricional de forma sistemática en las diferentes fases del proceso oncológico, y no existe consenso universal
en los protocolos de actuaciĂłn e intervenciĂłn nutricional. Existe un cumplimiento generalizado de los circuitos y tiempos de derivaciĂłn de los
procesos seleccionados. En la fase terapĂ©utica se dispone de la posibilidad de consultar a la Unidad de NutriciĂłn ClĂnica y DietĂ©tica (UNCYD) y el
75 % disponen de protocolos especĂficos de derivaciĂłn. La enfermera gestora de casos está presente en todos los hospitales y en AP. El acceso
del paciente al psicólogo del centro era posible en el 87 % de los hospitales. Escasa participación de la UNCYD en los Comités de Tumores (solo
en el 25 % de los centros). En todos los centros existe algĂşn tipo de colaboraciĂłn y apoyo de las asociaciones de pacientes y de la Escuela de
Pacientes, especialmente en las fases terapéuticas y de control y seguimiento.
Conclusiones: se observan variaciones entre los diferentes hospitales y territorios de AndalucĂa, tanto en la disposiciĂłn de medios y estructuras
como en las actividades y procedimientos. Se han seleccionado y priorizado puntos clave para mejorar la atenciĂłn nutricional en oncologĂa.Introduction: malnutrition in cancer patients can lead to a reduction in patient quality of life, increased morbidity and mortality, and associated
healthcare costs.
Objective: to analyze nutritional interventions in the different phases of the oncological process, integrating the needs of patients and those of
healthcare professionals.
Material and methods: “Design Thinking” techniques were used to address the analysis of the current situation and identify key aspects.
Thirteen professionals from 8 public health centers (endocrinology and nutrition, medical and radiotherapy oncology, primary care (PC), nursing
and dietetics) participated in the study.
Results: nutritional screening is not carried out in a systematic way in the different phases of the oncological process, and there is no universal
consensus on the protocols for action and nutritional intervention. A wide compliance with the pathways and referral times of the selected processes
has been observed. In the therapeutic phase, there is the possibility of consulting the Clinical Nutrition and Dietetics Unit (UNCYD) and 75 % have
specific referral protocols. The nurse case manager is present in all hospitals and in PC. Patient access to the center psychologist was possible in
87 % of the hospitals. Participation of the UNCYD in Tumor Committees was low (only in 25 % of the centers). In all centers there is some kind of
collaboration and support by patient associations and the School of Patients, especially in the therapeutic and the control and follow-up phases.
Conclusions: variations are observed between the different hospitals and areas in Andalusia, both in terms of means and structures and in
activities and procedures. Key points have been selected and prioritized to improve nutritional care in oncology
Análisis de las intervenciones nutricionales en el proceso asistencial del paciente oncolĂłgico en AndalucĂa: el proyecto NOA.
Introduction: malnutrition in cancer patients can lead to a reduction in patient quality of life, increased morbidity and mortality, and associated healthcare costs. Objective: to analyze nutritional interventions in the different phases of the oncological process, integrating the needs of patients and those of healthcare professionals. Material and methods: "Design Thinking" techniques were used to address the analysis of the current situation and identify key aspects. Thirteen professionals from 8 public health centers (endocrinology and nutrition, medical and radiotherapy oncology, primary care (PC), nursing and dietetics) participated in the study. Results: nutritional screening is not carried out in a systematic way in the different phases of the oncological process, and there is no universal consensus on the protocols for action and nutritional intervention. A wide compliance with the pathways and referral times of the selected processes has been observed. In the therapeutic phase, there is the possibility of consulting the Clinical Nutrition and Dietetics Unit (UNCYD) and 75 % have specific referral protocols. The nurse case manager is present in all hospitals and in PC. Patient access to the center psychologist was possible in 87 % of the hospitals. Participation of the UNCYD in Tumor Committees was low (only in 25 % of the centers). In all centers there is some kind of collaboration and support by patient associations and the School of Patients, especially in the therapeutic and the control and follow-up phases. Conclusions: variations are observed between the different hospitals and areas in Andalusia, both in terms of means and structures and in activities and procedures. Key points have been selected and prioritized to improve nutritional care in oncology
Data_Sheet_1_Prognostic value of bioelectrical impedance analysis in head and neck cancer patients undergoing radiotherapy: a VALOR® study.pdf
IntroductionBioelectrical impedance analysis (BIA) serves as a method to estimate body composition. Parameters such as phase angle (PA), standardized phase angle (SPA), body mass cell (BCM), BCM index (BCMI), and fat-free mass (FFM) might significantly impact the prognosis of head and neck cancer (HNC) patients. The present study aimed to investigate whether bioelectrical parameters can be used to predict survival in the HNC population and establish the optimal cutoff points for predictive accuracy.MethodsA multicenter observational study was performed across 12 tertiary hospitals in Andalusia (a region from the south of Spain). A total of 494 patients diagnosed with HNC between 2020 and 2022 at different stages were included in this study, with a minimum follow-up period of 12 months. The BIA assessment was carried out during the first 2 weeks of radical radiotherapy treatment with chemotherapy or other systemic treatments. A multivariate logistic regression analysis of overall survival, complications, hospital admission, and palliative care and its relationship with BIA nutritional assessment was performed.ResultsSignificant prognostic factors identified in the multivariable analysis encompassed phase angle (PA), standardized phase angle (SPA), body cell mass (BCM), and BCM index (BCMI). Lower PA and BCM values were significantly associated with adverse clinical outcomes. A BCM threshold above 17 kg/m2 was the most significant predictor for predicting survival within the overall HNC population. The PA values of ConclusionBIA is a crucial tool in the nutritional assessment of HNC patients. BCM and PA are the main bioelectrical parameters used to predict clinical outcomes in this population. Future studies are needed to validate BIA variables in a large cohort to ensure whether early intensification of nutritional treatment would improve survival.</p