Potential benefits of early nutritional intervention in adults with upper gastrointestinal cancer: a pilot randomised trial

作者：Silvers Mary Anne^*; Savva June; Huggins Catherine E; Truby Helen; Haines Terry

来源：Supportive Care in Cancer, 2014, 22(11): 3035-3044.

DOI：10.1007/s00520-014-2311-3

• Dietetics
• Oesophageal cancer
• Stomach cancer
• Quality of life

This study aimed to test whether a very early nutrition intervention delivered over the telephone was feasible and could improve outcomes amongst patients with upper gastrointestinal cancer. %26lt;br%26gt;Participants with a histologically proven new diagnosis of primary oesophageal or stomach cancer and who were to undergo surgery and/or chemotherapy were randomised to receive either standard nutrition care (SC) or early and intensive nutrition intervention (NI) over the telephone/face-to-face. Participants were followed for 6 months. The primary outcome was quality of life (QoL), assessed using the European Organization for Research and Treatment of Cancer Global Quality of Life questionnaire C30 (EORTC QLQ-C30) and the European Quality of Life Instrument (EQ-5D) tool; secondary outcomes were nutritional status and survival. %26lt;br%26gt;Twenty-one participants were recruited (11 SC and 10 NI). At baseline, the prevalence of malnutrition was 90 %. Compared with SC, the NI group had a significantly higher EORTC global QoL score at the first mid-study follow-up (coefficient (95 % CI) 21.0 (12.1, 29.9) adjusted for baseline, p %26lt; 0.001) and at 26 weeks (28.4 (21.3, 35.4) adjusted for baseline, p %26lt; 0.001). Nutritional risk score was lower (p %26lt; 0.001), and loss of body weight attenuated (p %26lt; 0.001) in the NI group compared with SC. Six deaths occurred during the study, five in the SC group and one in the NI group (p = 0.06). The mean time spent with a dietitian per contact was significantly less for the NI group compared with SC (16(3) vs 40(6) min per dietetic contact, p %26lt; 0.001). %26lt;br%26gt;This pilot study has shown the potential of a novel telephone-based early and intensive dietetic model of care for newly diagnosed upper gastrointestinal cancer patients.

• 出版日期2014-11