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Turkish Journal of Medical Sciences

Abstract

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Background/aim: Malnutrition and muscle wasting are common in terminal cancer patients and adversely affect prognosis. Bedside muscle ultrasonography (US) has emerged as a practical tool to assess nutritional status and monitor therapy. This study evaluated the relationship between achieving individualized nutritional targets and changes in muscle indices measured by US in terminal cancer patients receiving palliative care.

Materials and methods: Subcutaneous fat tissue thickness (SFTT), muscle thickness (MT), and cross-sectional area (CSA) of the rectus femoris (RF) and biceps brachii (BB) muscles were assessed by US over 10 days and normalized to height squared (m²). A total of 95 patients with complete retrospective data were included; 74.7% achieved their caloric targets, while 25.3% did not.

Results: Patients who failed to meet caloric goals exhibited significantly greater reductions across all muscle parameters. Among those who achieved caloric targets, protein intake ≥1.5 g/kg/day was associated with reduced muscle loss compared to lower intake. The RF muscle was particularly sensitive to nutritional status, exhibiting more pronounced changes in response to both caloric and protein adequacy. No significant differences were observed between feeding routes, although patients receiving parenteral nutrition tended to exhibit greater decline. Correlation analyses demonstrated a significant negative association between time to achieve caloric targets and muscle preservation, underscoring the importance of early intervention. Linear regression further identified delayed caloric achievement as an independent predictor of accelerated muscle loss.

Conclusion: Achieving caloric and high-protein targets is critical for preserving muscle mass in terminal cancer patients. US, particularly of the RF muscle, provides a reliable, noninvasive, and practical tool for monitoring the effects of nutritional interventions in this vulnerable population.

Author ORCID Identifier

İREM KIRAÇ UTKU: 0000-0003-3806-5291

BURCU ÇALIŞKAN AYDOĞMUŞ: 0009-0003-7587-1396

HATİCE NUR AVCIOĞLU: 0009-0000-6849-2898

MÜGE ÇATIKKAŞ: 0000-0003-2494-1625

AYFER DURAK: 0000-0002-0396-7802

DENİZ SEVİNDİK GÜNAY: 0000-0001-7467-1112

UMUT SAFER: 0000-0002-9763-4370

DOI

10.55730/1300-0144.6074

Keywords

malnutrition, Quadriceps muscle, rectus femoris, terminal care

First Page

1197

Last Page

1212

Publisher

The Scientific and Technological Research Council of Türkiye (TÜBİTAK)

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

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