Integral nutritional approach to the care of cancer patients: results from a Delphi panel

Durán-Poveda, Manuel; Jiménez‐Fonseca, Paula; Sirvent-Ochando, Mariola; García-Luna, Pedro Pablo; Cunill, José Luis Pereira; Lema-Marqués, B.; Parejo-Arrondo, M. T.; Belda-Iniesta, Cristóbal

doi:10.1007/s12094-018-1846-z

Cited by 26 publications

(23 citation statements)

References 27 publications

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“…This may be partly attributed to the lack of uniformity in the cut-off used to define sarcopenia on computed tomography (CT) images; this would directly influence the statistical results. Selection bias caused by the difference in patients' clinical stage is also likely to affect the results [18,19]. Therefore, we evaluated the sarcopenic status in the Japanese population using cut-off values established and used specifically in this ethnic population.…”

Section: Discussionmentioning

confidence: 99%

“…Dietary counseling and nutritional support have also been reported to positively influence morbidity outcomes and QOL in cancer patients undergoing radiation therapy [33]. Early consultation with a skilled nutritionist is widely accepted to be beneficial for cancer patients receiving anticancer treatments [18,19,[34][35][36] and for those in advanced stages of malignancy [37]. Collectively, these findings indicate that clinicians should carefully evaluate patients' nutritional conditions, with particular emphasis on the presence of sarcopenia, and consider nutritional interventions throughout the disease course.…”

Section: Discussionmentioning

confidence: 99%

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Sarcopenic Factors May Have No Impact on Outcomes in Ovarian Cancer Patients

Nakayama

Nakamura

et al. 2019

Diagnostics

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Although the prognostic value of sarcopenic factors, such as loss of muscle mass and quality, have been widely reported in patients with cancer during the last decade, the value in those with ovarian cancer remains unclear. Therefore, this study evaluated the prognostic impact of sarcopenic factors in patients with ovarian cancer. We retrospectively evaluated the data of 94 ovarian cancer patients who underwent surgery and chemotherapy at the Shimane University Hospital between March 2006 and 2013. Preoperative computed tomography scan at the level of the third lumbar vertebra was used to evaluate skeletal muscle volume and quality based on the skeletal muscle index (SMI) and intramuscular adipose tissue content (IMAC), respectively. The impact of preoperative SMI and IMAC on outcomes was subsequently investigated. Low SMI and high IMAC were not significantly associated with disease-free survival (p = 0.329 and p = 0.3370, respectively) or poor overall survival (p = 0.921 and p = 0.988, respectively). Neither preoperative low muscle volume nor low muscle quality was a poor prognostic factor in ovarian cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Sarcopenic Factors May Have No Impact on Outcomes in Ovarian Cancer Patients

Nakayama

Nakamura

et al. 2019

Diagnostics

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“…Nowadays, there is a wide agreement that early consultation with a professional (physician and dietician) with documented skills in clinical nutrition, specifically for oncology patients, is beneficial for cancer patients receiving anticancer treatments [19,21,[25][26][27] as well as for those in the advanced stages of disease [22]. However, there are few clinical studies investigating the effects of nutritional support in cancer patients undergoing CT or radiotherapy (RT).…”

Section: Evidence Supporting Nutritional Interventionsmentioning

confidence: 99%

Nutritional Therapy in Cancer Patients Receiving Chemoradiotherapy: Should We Need Stronger Recommendations to Act for Improving Outcomes?

Cotogni¹,

Pedrazzoli²,

Waele³

et al. 2019

J. Cancer

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One of the challenges during chemotherapy and radiotherapy is to complete the planned cycles and doses without dose-limiting toxicity. Growing evidence clearly demonstrates the relationship between dose-limiting toxicity and low muscle mass. Moreover, malnutrition leads to low performance status, impaired quality of life, unplanned hospital admissions, and reduced survival. In the past, the lack of clear and authoritative recommendations and guidelines has meant that oncologists have not always fully appreciated the importance of nutritional therapy in patients receiving anticancer treatments. Therefore, collaboration between oncologists and clinical nutrition specialists needs to be urgently improved. Recent guidelines from scientific societies and practical recommendations by inter-society consensus documents can be summarized as follows: 1) timely nutritional therapy should be carefully considered if patients undergoing anticancer treatments are malnourished or at risk of malnutrition due to inadequate oral intake; 2) if oral intake is inadequate despite counseling and oral nutritional supplements, supplemental enteral nutrition or, if this is not sufficient or feasible, parenteral nutrition should be considered; 3) home artificial nutrition should be prescribed and regularly monitored using defined protocols developed between oncologists and clinical nutrition specialists; 4) appropriate nutritional management in the context of simultaneous care should become a guaranteed right for all patients with cancer. The purpose of this review is to provide oncologists with an overview of the aims and current evidence about nutrition in oncology, together with updated practical and concise recommendations on the application of nutritional therapy in cancer patients receiving chemoradiotherapy.

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“…However, the most alarming aspect reported in the preliminary results of this study is the large number of cancer patients in Spain for whom no nutritional diagnosis is made. In this respect, Duran-Poveda et al conducted a study using the Delphi method, involving 52 medical specialists who treated cancer patients, and found that fewer than 30% of these patients were screened to assess their risk of malnutrition [13].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a protocol to detect malnutrition and provide nutritional care for cancer patients undergoing chemotherapy

Sanz

Abilés

Siles

et al. 2020

Preprint

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Background Patients with cancer frequently experience malnutrition, which is associated with higher rates of morbidity and mortality. Therefore, the implementation of strategies for its early detection and for intervention should improve the evolution of these patients. Our study aim is to design and implement a protocol for outpatients starting chemotherapy, by means of which any malnutrition can be identified and treated at an early stage. Methods Before starting chemotherapy for patients with cancer, a complete assessment was made of their nutritional status, using the Nutriscore screening tool. When nutritional risk was detected, an interventional protocol was applied. Results Of 234 patients included in the study group, 84 (36%) required an individualised nutritional approach: 27 (32.1%) presented high nutritional risk, 12 had a Nutriscore result ≥ 5 and 45 experienced weight loss during chemotherapy. Among this population, the mean weight loss (with respect to normal weight) on inclusion in the study was − 3.6% ±8.2. By the end of the chemotherapy, the mean weight gain was 0% ±7.3 (p < 0.001) and 71.0% of the patients had experienced weight gain or maintenance, with respect to the initial weight. Conclusion More than a third of cancer patients who start chemotherapy are candidates for early nutritional intervention. This finding highlights the importance of early identification of patients at risk in order to improve the efficacy of nutritional interventions, regardless of the stage of the disease.

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Integral nutritional approach to the care of cancer patients: results from a Delphi panel

Cited by 26 publications

References 27 publications

Sarcopenic Factors May Have No Impact on Outcomes in Ovarian Cancer Patients

Sarcopenic Factors May Have No Impact on Outcomes in Ovarian Cancer Patients

Nutritional Therapy in Cancer Patients Receiving Chemoradiotherapy: Should We Need Stronger Recommendations to Act for Improving Outcomes?

Evaluation of a protocol to detect malnutrition and provide nutritional care for cancer patients undergoing chemotherapy

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