Expert consensus on nutrition therapy in cancer patients receiving radiotherapy
1Sichuan Cancer Hospital Institute/Sichuan Cancer Center/School of Medicine, University of Electronic Science & Technology of China, Chengdu 610041, Sichuan; 2Beijing ShijitanHospital, Capital Medical University, Beijing 100038, China; 3Daping Hospital, Research Institute of Surgery Third Military Medical University, Chongqing 400042, China;4Shandong Cancer Hospital, Jinan 250021, Shandong, China; 5Fudan University Shanghai Cancer Center, Shanghai 200032, China; 6The Fourth Hospital of Hebei Medical University, Shijiazhuang 050010, Hebei, China; 7Zhejiang Cancer Hospital, Hangzhou 310022, Zhejiang, China; 8Navy General Hospita, Bejing 100048, China; 9Beijing Cancer Hospital, Beijing 100142, China; 10Fujian Cancer Hospital, Fuzhou 350014, Fujian, China; 11Sun Yat-Sen University Cancer Hospital /Sun Yat-sen University Cancer Center, guangzhou 510060, Guangdong, China; 12Jilin Cancer Hospital ,Changchun 130012, Jilin, China; 13The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China; 14The First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning, China; 15Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei, China; 16
The People's Hospital of Guizhou Province, Guiyang 550002, Guizhou, China; 17Department of Jilin University, First Clinical Hospital, Changchun 130021, Jilin China; 18Cancer Hospital Chinese Academy of Medical Science, Beijing 100021, China; 19Xiangya Hospital of Centre-south University, Changsha 410008, Hunan, China; 20The Second Affiliated Hospital of Dalian Medical University, Dalian 116021, Liaoning, China; 21General Hospital of Ningxia Medical University,Yinchuan 750004, Ningxia, China; 22The First Affiliated Hospital of Kunming Medical University, Kunming 650031, Yunnan, China; China Society for Nutritional Oncologyl, Chinese Anti-Cancer Association; Chinese Medical Doctor Association Radiotherapy Doctors Chapter Nutrition Therapy Branch
Abstract：Abstract: The incidence of malnutrition was high in cancer patients receiving radiotherapy. Malnutrition may reduce the antitumor effect and increase the radiotherapy adverse reactions. NRS 2002 is recommended for nutritional risk screening, and PG-SGA is recommended for nutritional assessment. The cancer patients receiving radiotherapy should carry out whole-process nutrition management during the peri-radiation period. We should correctly assess the nutritional status of patients using PG-SGA before, during and after radiotherapy and acute radiation injury during and after radiotherapy according to RTOG criteria. Then, we can select the standardized and individualized nutrition treatment method according to the assessment result. Nutritional therapy should follow the "five-stage model". Enteral nutrition access should follow the "four-stage model". Only when the patient is unable to obtain adequate nutritional needs through enteral nutrition or the presence of severe radioactive mucositis, radiation enteritis or intestinal failure, it is recommended to combine partal or whole enteral nutrition in time. The recommended amount of energy intake for radiotherapy patients with malignant tumor is 25~30kcal/(kg·d). It should be adjusted dynamically according to tumor burden, stress state and acute radiation injury during radiotherapy. Cancer patients receiving radiotherapy are recommend higher protein intake, and 1.5~ 2.0g/(kg·d) is recommended for patients with severe malnutrition. For patients with cachexia, it can be increased to 2.0g/(kg·d).
2018, Vol. 5 
