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Supportive Care in Cancer
Published in: Supportive Care in Cancer 10/2017

Open Access 01-10-2017 | Original Article

Feeding strategies in pediatric cancer patients with gastrointestinal mucositis: a multicenter prospective observational study and international survey

Authors: Nicoline S.S. Kuiken, Edmond H.H.M. Rings, Marry M. van den Heuvel-Eibrink, Marianne D. van de Wetering, Wim J.E. Tissing

Published in: Supportive Care in Cancer | Issue 10/2017

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Abstract

Introduction

Currently, there is no adequate prevention or treatment for both oral and gastrointestinal mucositis induced by chemotherapy and/or radiotherapy. Supportive care of symptoms plays a primary role during mucositis in the pediatric clinical setting. We aimed to get insight in the currently used feeding strategies in clinical practice in pediatric cancer patients with chemotherapy-induced mucositis.

Methods

A prospective observational study was performed to identify feeding strategies after chemotherapy courses causing mucositis in almost all patients at the University Medical Center Groningen (UMCG), the Academic Medical Center Amsterdam (AMC), and the Princess Maxima Center Utrecht (PMC). Consecutive patients, aged 0–18 years, either diagnosed with B cell non-Hodgkin lymphoma (B-NHL) or scheduled for autologous stem cell transplantation (SCT) between April 2015 and September 2016 were included in this study. In addition to the observational study in the Netherlands, an international online questionnaire was conducted for pediatric oncology centers.

Results

A total of 13 patients were included, after 21 chemotherapy courses. No nutritional support was administered after 23.8% courses, tube feeding after 19.0% of the courses, TPN in 19.0% of courses, and 38.1% received a combination of tube feeding and TPN. The international survey revealed that 63.2% of the centers administered tube feeding as first choice, 31.6% administered only TPN as first choice, and one center administered a combination as first choice.

Conclusions

There is a variability in feeding strategies in the clinical practice both in the Netherlands as well as worldwide. This study is a basis for future studies in this important clinical field to develop clinical trials comparing tube feeding and TPN both in adult and pediatric patients.
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Metadata
Title
Feeding strategies in pediatric cancer patients with gastrointestinal mucositis: a multicenter prospective observational study and international survey
Authors
Nicoline S.S. Kuiken
Edmond H.H.M. Rings
Marry M. van den Heuvel-Eibrink
Marianne D. van de Wetering
Wim J.E. Tissing
Publication date
01-10-2017
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 10/2017
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-017-3715-7

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