Symptom burden strongly correlates with the need for a dietitian in advanced NSCLC

Phillips, I.; Allan, Lindsey A.; Hug, Adele; Westran, N.; Heinemann, Claudia; Hewish, Madeleine; Mehta, Anuj; Saxby, Helen; Mainsiouw, L.; Boateng, S.; Evans, Philip; Ezhil, Veni

doi:10.1016/s0169-5002(20)30214-2

Cited by 3 publications

(2 citation statements)

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“…Need for formalised dietetic input is high. In a previous study, we identified that 78% of NSCLC patients needed to see a dietitian and 52% met criteria for a critical need to see a dietitian [47]. Other studies have confirmed this result [48].…”

Section: Cachexia and Nutritional Screeningmentioning

confidence: 61%

Optimising Outcomes in Non Small Cell Lung Cancer: Targeting Cancer Cachexia

Phillips¹,

Stares²,

Allan³

et al. 2022

Front. Biosci. (Landmark Ed)

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Lung cancer is the commonest malignancy worldwide and the leading cause of cancer death. Half of patients with lung cancer present with advanced disease. The number of systemic therapies including immunotherapy and targeted treatment are rapidly increasing. Despite this, the outcomes for many patients with locally advanced and advanced lung cancer are poor, as many patients are too unwell for treatment. One of the reasons patients with Non-Small Cell Lung Cancer are not fit for treatment is cancer cachexia, which is common (upto 75% of patients) in this group. This metabolic syndrome presents clinically as weight loss (muscle +/-fat), decreased physical function (patients less active) and anorexia on a background of systemic inflammation. Currently there is not an optimal management pathway for these patients, however, there is emerging data that multi-modal intervention including nutritional support, physical training and pharmacological therapy may have a role in treating cachexia. This review discusses assessment and intervention in cancer cachexia.

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Section: Cachexia and Nutritional Screeningmentioning

confidence: 61%

Optimising Outcomes in Non Small Cell Lung Cancer: Targeting Cancer Cachexia

Phillips¹,

Stares²,

Allan³

et al. 2022

Front. Biosci. (Landmark Ed)

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“…Cancer associated malnutrition has resulted in greater challenges when delivering chemotherapy 4–7. Assessing nutritional status early is, therefore, vital in patients with advanced lung cancer 8 9…”

Section: Introductionmentioning

confidence: 99%

Early dietitian referral in lung cancer: use of machine learning

Chung

Phillips

Allan

et al. 2022

BMJ Support Palliat Care

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ObjectivesThe Dietetic Assessment and Intervention in Lung Cancer (DAIL) study was an observational cohort study. It triaged the need for dietetic input in patients with lung cancer, using questionnaires with 137 responses. This substudy tested if machine learning could predict need to see a dietitian (NTSD) using 5 or 10 measures.Methods76 cases from DAIL were included (Royal Surrey NHS Foundation Trust; RSH: 56, Frimley Park Hospital; FPH 20). Univariate analysis was used to find the strongest correlates with NTSD and ‘critical need to see a dietitian’ CNTSD. Those with a Spearman correlation above ±0.4 were selected to train a support vector machine (SVM) to predict NTSD and CNTSD. The 10 and 5 best correlates were evaluated.Results18 and 13 measures had a correlation above ±0.4 for NTSD and CNTSD, respectively, producing SVMs with 3% and 7% misclassification error. 10 measures yielded errors of 7% (NTSD) and 9% (CNTSD). 5 measures yielded between 7% and 11% errors. SVM trained on the RSH data and tested on the FPH data resulted in errors of 20%.ConclusionsMachine learning can predict NTSD producing misclassification errors <10%. With further work, this methodology allows integrated early referral to a dietitian independently of a healthcare professional.

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Optimising patient fitness: strategies to reduce the effects of cancer cachexia in patients with advanced lung cancer

Phillips

Kestenbaum²

2020

Current Opinion in Supportive &Amp; Palliative Care

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Purpose of review Outcomes for patients with advanced lung cancer have traditionally been very poor. This patient group are often comorbid, less fit and experience multiple symptoms. This review discusses strategies for minimizing the impact of cachexia on patients with advanced lung cancer. This is timely, as in recent years there has been a rapid increase in available systemic therapy options, with the potential of long-term survival for some patients. Recent findings The review discusses current strategies in combating cachexia, including: symptom control, systemic therapy for cancer and for cachexia, nutritional interventions and exercise interventions. It discusses current clinical trials, combining interventions and the paradigm of prehabilitation. Summary It is likely that the optimal way of minimizing the impact of cachexia in advanced lung cancer is through a combination of early interventions including symptom management.

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Symptom burden strongly correlates with the need for a dietitian in advanced NSCLC

Cited by 3 publications

References 0 publications

Optimising Outcomes in Non Small Cell Lung Cancer: Targeting Cancer Cachexia

Optimising Outcomes in Non Small Cell Lung Cancer: Targeting Cancer Cachexia

Early dietitian referral in lung cancer: use of machine learning

Optimising patient fitness: strategies to reduce the effects of cancer cachexia in patients with advanced lung cancer

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