Is Nutritional Intervention Relevant in Patients withCancer and Weight Loss who are to Receive Chemotherapy

• Main Author: Baldwin, Christine
• Published: Imperial College London 2008
• Subjects: 616.99
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.506831

Weight loss in patients with gastrointestinal (GI) cancers predisposes to decreased survival and reduced quality of life (QOL). These studies investigated the prevalence, clinical correlates and management of GI cancer patients with weight loss and undertook a randomised controlled trial (RCT), to determine whether or not nutritional interventions could have a positive impact on relevant endpoints. The prevalence of greater than 10% weight loss was 17% in patients with lower GI cancer and 56% in patients with upper GI disease. The greatest weight loss was associated with the most advanced upper GI tract tumours. Out-patient staff failed to identify and manage most patients with weight loss, referring 9% of patients with> 10% weight loss for dietetic help. A survey of 54 trainee oncologists indicated that 74% were uncertain about how to identify malnutrition and highlighted a lack of knowledge and clear guidelines as the principal reasons for failing to address nutritional issues. Meta-analysis of data from 17 RCTs was used to determine the evidence base for nutritional intervention in the management of weight loss in cancer. There were no significant differences in survival or nutritional status between patients receiving nutritional interventions or routine care. Notably, all studies were underpowered and much of the data were unusable.