Q24. What nutritional parameters need to be monitored?
The three level II positive quality studies in which dietetic counselling was provided weekly during treatment and then fortnightly post treatment monitored the following parameters of weight, fat free mass, nutritional status, global quality of life, and nutritional intake via diet history . These were sufficient parameters to show improvements in patient outcomes. Fat free mass and global quality of life were parameters for research purposes and may not be required in everyday practice. Monitoring of weight change during and post treatment, either alone or in addition to nutritional status, was further supported by one level III-1 neutral quality study  and two level III-3 neutral quality studies .
One level IV neutral quality study reported on the changes in nutritional status, body weight, intake, albumin and micronutrient status (zinc, copper) during radiotherapy, with all measures significantly decreasing during treatment . Another level IV study (negative quality) compared selenium levels pre and post radiotherapy and found that these are reduced during radiotherapy. Selenium status is also lower at baseline compared to healthy controls, and remains lower in those patients that have residual disease . One final level IV neutral quality study  reported on hyperglycaemia during concurrent chemoradiotherapy and suggested that BGL’s should also be monitored.
|Monitor weight, intake and nutritional status during and post (chemo) radiotherapy.||A|
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