Influence of a nutritional intervention on dietary intake and quality of life in cancer patients: A randomized controlled trial

Uster, A.; Ruefenacht, U.; Ruehlin, Maya; Pless, Miklos; Siano, Marco; Haefner, Mark; Imoberdorf, Reinhard; Ballmer, Peter E.

doi:10.1016/j.nut.2013.05.004

Cited by 79 publications

(87 citation statements)

References 27 publications

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“…Uster et al, who examined cancer outpatients for effects of nutritional therapy, reported a higher energy and protein intake but no benefit on QoL in their intervention group. Surprisingly, the standard group had a significantly better QoL [41]. In our study physical, role, emotional and social function developed divergently between parenterally fed patients and the controls during hospital stay but were not significant, thus representing only a trend.…”

Section: Discussioncontrasting

confidence: 53%

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Early Parenteral Nutrition in Patients with Biliopancreatic Mass Lesions, a Prospective, Randomized Intervention Trial

et al. 2016

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PurposePatients with biliopancreatic tumors frequently suffer from weight loss and cachexia. The in-hospital work-up to differentiate between benign and malignant biliopancreatic lesions requires repeated pre-interventional fasting periods that can aggravate this problem. We conducted a randomized intervention study to test whether routine in-hospital peripheral intravenous nutrition on fasting days (1000 ml/24 h, 700 kcal) has a beneficial effect on body weight and body composition.Material and Methods168 patients were screened and 100 enrolled in the trial, all undergoing in-hospital work-up for biliopancreatic mass lesions and randomized to either intravenous nutrition or control. Primary endpoint was weight loss at time of hospital discharge; secondary endpoints were parameters determined by bioelectric impedance analysis and quality of life recorded by the EORTC questionnaire.ResultsWithin three months prior to hospital admission patients had a median self-reported loss of 4.0 kg (25*th: -10.0 kg and 75*th* percentile: 0.0kg) of body weight. On a multivariate analysis nutritional intervention increased body weight by 1.7 kg (95% CI: 0.204; 3.210, p = 0.027), particularly in patients with malignant lesions (2.7 kg (95% CI: 0.71; 4.76, p < 0.01).ConclusionsIn a hospital setting, patients with suspected biliopancreatic mass lesions stabilized their body weight when receiving parenteral nutrition in fasting periods even when no total parenteral nutrition was required. Analysis showed that this effect was greatest in patients with malignant tumors. Further studies will be necessary to see whether patient outcome is affected as well.Trial RegistrationClinicalTrials.gov NCT02670265

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Section: Discussioncontrasting

confidence: 53%

“…Some studies have concentrated on weight stabilization and its association with QoL [8,38,39,41,42]. Patients with unresectable cancer who showed a stable weight (≤1 kg weight loss) after an eight—week nutrition intervention improved in QoL and even showed prolonged survival [8].…”

Section: Discussionmentioning

confidence: 99%

Early Parenteral Nutrition in Patients with Biliopancreatic Mass Lesions, a Prospective, Randomized Intervention Trial

et al. 2016

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“…[12][13][14][15] Intensive nutrition intervention seems to improve dietary intake. 16 Dietary counseling combined with oral nutritional supplementation was associated with relatively low toxicity scores and interrupting treatment.…”

Section: Introductionmentioning

confidence: 99%

Dietary counselling and nutritional support in oropharyngeal cancer patients treated with radiotherapy: persistent weight loss during 1-year follow-ups

et al. 2015

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This study showed that patients continue to lose body weight during and until 1 year after treatment, despite nutrition support and frequent dietetic consultation. A BMI above average appears to increase survival time. Future studies, preferably randomized trials, are needed to compare standard dietary counselling with more intensive dietary counselling that consists of earlier and/or prolonged treatment.

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“…This approach aims to maximise calories, nutrients and taste (Uster et al, 2013). In a situation where screening reveals that patients have multiple causes of weight loss it may be useful to refer to a dietician who can take the time to identify strategies for addressing each of the contributory factors.…”

Section: Specific Nutritional Screening Questionsmentioning

confidence: 99%

Nutrition and palliative care

Watson

Rodgers²

2015

InnovAiT: Education and inspiration for general practice

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Requests to GPs for nutritional supplements for patients approaching the end of life are common. Commercially available food supplements are expensive and often prescribed inappropriately, costing the NHS large sums every year. Judging whether it is appropriate to prescribe nutritional supplements in palliative care situations is difficult. The decision will depend on many different factors including the stage of the patient’s illness, and the wishes of the patient and family. This article explores nutrition in palliative care with the aim of providing GPs with some simple tools to use to decide whether nutritional supplements are appropriate and what form they should take.

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Influence of a nutritional intervention on dietary intake and quality of life in cancer patients: A randomized controlled trial

Cited by 79 publications

References 27 publications

Early Parenteral Nutrition in Patients with Biliopancreatic Mass Lesions, a Prospective, Randomized Intervention Trial

Early Parenteral Nutrition in Patients with Biliopancreatic Mass Lesions, a Prospective, Randomized Intervention Trial

Dietary counselling and nutritional support in oropharyngeal cancer patients treated with radiotherapy: persistent weight loss during 1-year follow-ups

Nutrition and palliative care

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