EFFECTS OF NASO-GASTRIC TUBE-FEEDING ON THE NUTRITIONAL-STATUS OF CHILDREN WITH CANCER

Objective: To study the effect of sufficient energy intake, by means o f the protocolized administration of nasogastric tube feeding, on the nutritional status of a child with cancer. Design: A comparative exper imental study. Setting: Tertiary care at the Centre for Pediatric Onco logy, South East Netherlands, University Hospital, Nijmegen. Subjects: Seven children, newly diagnosed with cancer, were included in the exp erimental study and all completed the trial period. Fourteen patients were included in the retrospective study. They were randomly chosen fr om a group of patients previously treated for a malignancy at our depa rtment and who had received naso-gastric tube feeding for at least 16 weeks. Intervention: Protocolized (experimental group) vs non-protocol ized (retrospective group) administration of naso-gastric tube feeding over a period of 16 weeks. The main difference was the amount of tube feeding administered. In addition to energy from other foods, childre n in the experimental group received 106 +/- 13% of their total dairy energy requirements (TDER) by means of tube feeding, whereas children in the retrospective group had received 75 +/- 24%. Main outcome measu res: Weight as a percentage of weight for height according to the 50th percentile of a healthy reference population = ideal weight. Results: Weight, expressed as a percentage of the ideal weight, increased sign ificantly in the experimental group (18.2 +/- 8.4; P = 0.01) and the r etrospective study group (5.2 +/- 7.3; P = 0.001). However, the increa se was statistically significant in favour of the experimental group ( P = 0.003), in which all the children reached their ideal weight, comp ared to 21% in the retrospective group. Conclusion: Aggressive protoco lized nutritional intervention during the intensive phase of anti-canc er treatment, in the form of naso-gastric tube feeding that provides t he child's total daily energy requirements, results in considerable im provement in the nutritional status.