Nutritional status during initial childhood cancer treatment: A retrospective cohort study

Abstract

Background

Malnutrition is a common problem in pediatric oncology. However, most studies only measure weight at diagnosis and the end of treatment, missing the critical early period. This study aimed to track month-by-month nutritional changes during the first 60 days of chemotherapy to identify when weight loss occurs.

Methods

We analyzed medical records of 130 children (aged 0–18 years) treated for cancer. Anthropometric data (height and weight) were collected at diagnosis (TM0), one month (TM1), and two months (TM2). Nutritional status was assessed using weight-for-height Z-scores for children <5 years and BMI-for-age Z-scores for those ≥5 years, harmonized into a single WHZ/BMIZ variable based on World Health Organization standards. Longitudinal changes in continuous Z-scores were analyzed using the Friedman test, while changes in categorical malnutrition prevalence were assessed using Cochran's Q test.

Results

The study included 130 patients (63.8% male). The mean WHZ/BMIZ score declined from −0.18 at diagnosis to −0.46 at one month, before recovering to −0.10 at two months; this change was not statistically significant (p = 0.156). The overall prevalence of malnutrition (moderate and severe acute malnutrition combined) remained stable across time points (p = 0.840). However, severe acute malnutrition peaked transiently at one month (16.2%) before returning to baseline. Subgroup analysis revealed that adolescents aged 10–14 years were the only group to experience a statistically significant nutritional decline (p = 0.009).

Conclusion

Overall nutritional status remained stable during the first 60 days of cancer treatment; however, specific vulnerabilities were identified. Adolescents aged 10–14 years experienced significant nutritional deterioration, and a transient peak in severe acute malnutrition was observed at one month. Targeted nutritional monitoring and early intervention should focus on these high-risk groups and timeframes.