Developing a supportive care pathway for sarcopenia prevention in nasopharyngeal carcinoma: a context-sensitive and implementation-oriented approach.
6 affiliations
- 1Department of Radiotherapy, General Hospital of Ningxia Medical University, 804 Shengli South Street, Xingqing District, Yinchuan, 750004, Ningxia, China. [email protected].
- 2Graduate School of Nursing Science, St. Luke's International University, 10-1 Akashi-Cho, Chuo-Ku, Tokyo, 104-0044, Japan. [email protected].
- 3Nursing School, Ningxia Medical University, No. 1160 Shengli Street, Xingqing District, Yinchuan, 750004, Ningxia, China. [email protected].
- 4Department of Radiotherapy, General Hospital of Ningxia Medical University, 804 Shengli South Street, Xingqing District, Yinchuan, 750004, Ningxia, China.
- 5Nursing School, Ningxia Medical University, No. 1160 Shengli Street, Xingqing District, Yinchuan, 750004, Ningxia, China.
- 6Graduate School of Nursing Science, St. Luke's International University, 10-1 Akashi-Cho, Chuo-Ku, Tokyo, 104-0044, Japan. [email protected].
Abstract
Purpose
Patients with nasopharyngeal carcinoma (NPC) undergoing definitive treatment commonly experience muscle loss, nutritional deterioration, symptom burden, and functional decline, increasing sarcopenia risk. This study aimed to develop a context-sensitive supportive care pathway integrating multidisciplinary care strategies for sarcopenia prevention across the NPC treatment trajectory.Methods
A multidisciplinary team (MDT) developed the pathway iteratively, guided by the updated Medical Research Council framework for complex interventions. Development integrated evidence synthesis, semi-structured interviews with healthcare professionals, programme theory, economic and resource considerations, contextual analysis, and informal consultations with patients and family caregivers. These inputs informed implementation requirements, professional roles, longitudinal care procedures, and core supportive care domains.Results
Evidence was most extensive for nutritional interventions; evidence for exercise and probiotic approaches was more limited and heterogeneous. Interviews with 21 healthcare professionals generated three themes comprising 11 subthemes, synthesised into four implementation requirements: recognition and professional competency; care organisation and MDT coordination; longitudinal monitoring and continuity of care; and patient self-management and family-supported care. Patient and caregiver consultations informed refinements to education, home-based self-management, and family involvement. The final pathway specified MDT roles, six longitudinal care procedures, and five integrated domains: nutritional and immune management, exercise management, head and neck symptom cluster management, gastrointestinal symptom cluster management, and psycho-behavioural support.Conclusion
The resulting pathway provides a context-sensitive, implementation-informed structure for coordinating multidisciplinary sarcopenia prevention across the NPC treatment trajectory. It incorporates clinical workflow, resource considerations, and continuity of care, but its feasibility, implementation, and effectiveness require prospective evaluation.
Related
- Developing the supportive care bundle for mothers of infants hospitalised in the neonatal intensive care unit: protocol for a multimethod study
- Beyond BMI: The Clinical Relevance of Sarcopenia and Muscle Quality in Gynecologic Oncology from Meta-Analyses to Practice—The Potential Role of Body Composition Assessment, Including BIA, in Supportive Care
- Implementation of a structured early oral supportive-care pathway and early oral health recovery after oral cancer resection and free-flap reconstruction: a prospective observational cohort study
- Using electronic patient reported outcomes (ePROs) to improve supportive care in ambulatory oncology care: a CFIR-guided pre-implementation formative evaluation
- Developing a scoring tool for assessing adherence to morbidity management and disability prevention (MMDP) practices in patients with filarial lymphedema: A pilot study
BibTeX
@article{xia2026developing,
title = {{Developing a supportive care pathway for sarcopenia prevention in nasopharyngeal carcinoma: a context-sensitive and implementation-oriented approach.}},
author = {Lijuan Xia and Sujuan Chen and Jia Min and Zhifang Ma and Yuning Zhang and Fengfei Zhang and Sha Liu and Bin Yan and Naoko Hayashi},
journal = {Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer},
year = {2026},
month = oct,
doi = {10.1007/s00520-026-11242-4},
url = {https://europepmc.org/article/MED/42834235},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Developing a supportive care pathway for sarcopenia prevention in nasopharyngeal carcinoma: a context-sensitive and implementation-oriented approach.
AU - Lijuan Xia
AU - Sujuan Chen
AU - Jia Min
AU - Zhifang Ma
AU - Yuning Zhang
AU - Fengfei Zhang
AU - Sha Liu
AU - Bin Yan
AU - Naoko Hayashi
PY - 2026
DA - 2026/10/05
JO - Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
DO - 10.1007/s00520-026-11242-4
UR - https://europepmc.org/article/MED/42834235
AB - Purpose Patients with nasopharyngeal carcinoma (NPC) undergoing definitive treatment commonly experience muscle loss, nutritional deterioration, symptom burden, and functional decline, increasing sarcopenia risk. This study aimed to develop a context-sensitive supportive care pathway integrating multidisciplinary care strategies for sarcopenia prevention across the NPC treatment trajectory.Methods A multidisciplinary team (MDT) developed the pathway iteratively, guided by the updated Medical Research Council framework for complex interventions. Development integrated evidence synthesis, semi-structured interviews with healthcare professionals, programme theory, economic and resource considerations, contextual analysis, and informal consultations with patients and family caregivers. These inputs informed implementation requirements, professional roles, longitudinal care procedures, and core supportive care domains.Results Evidence was most extensive for nutritional interventions; evidence for exercise and probiotic approaches was more limited and heterogeneous. Interviews with 21 healthcare professionals generated three themes comprising 11 subthemes, synthesised into four implementation requirements: recognition and professional competency; care organisation and MDT coordination; longitudinal monitoring and continuity of care; and patient self-management and family-supported care. Patient and caregiver consultations informed refinements to education, home-based self-management, and family involvement. The final pathway specified MDT roles, six longitudinal care procedures, and five integrated domains: nutritional and immune management, exercise management, head and neck symptom cluster management, gastrointestinal symptom cluster management, and psycho-behavioural support.Conclusion The resulting pathway provides a context-sensitive, implementation-informed structure for coordinating multidisciplinary sarcopenia prevention across the NPC treatment trajectory. It incorporates clinical workflow, resource considerations, and continuity of care, but its feasibility, implementation, and effectiveness require prospective evaluation.
SN - 0941-4355
SN - 1433-7339
ER -