Effect of whole-course nutrition management on patients with esophageal cancer undergoing concurrent chemoradiotherapy: A randomized control trial

Yanfang Qiu; Jie You; Kunlun Wang; Yuan Cao; Youchun Hu; Han Zhang; Rong Fu; Yafei Sun; Huanan Chen; Ling Yuan; Quanjun Lyu

doi:10.1016/j.nut.2019.110558

Effect of whole-course nutrition management on patients with esophageal cancer undergoing concurrent chemoradiotherapy: A randomized control trial

Nutrition. 2020 Jan:69:110558. doi: 10.1016/j.nut.2019.110558. Epub 2019 Jul 23.

Authors

Yanfang Qiu¹, Jie You², Kunlun Wang³, Yuan Cao⁴, Youchun Hu⁴, Han Zhang⁴, Rong Fu⁴, Yafei Sun⁴, Huanan Chen⁴, Ling Yuan³, Quanjun Lyu⁵

Affiliations

¹ Department of radiotherapy, Henan Tumor Hospital and Affiliated Tumor Hospital of Zhengzhou University, Zhengzhou, China; Department of Nutrition and Food Hygiene, College of Public Health, and the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
² Department of clinical nutrition, The third affiliated hospital of Zhengzhou University, Zhengzhou, China.
³ Department of radiotherapy, Henan Tumor Hospital and Affiliated Tumor Hospital of Zhengzhou University, Zhengzhou, China.
⁴ Department of Nutrition and Food Hygiene, College of Public Health, and the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
⁵ Department of Nutrition and Food Hygiene, College of Public Health, and the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China. Electronic address: lqjnutr@zzu.edu.cn.

PMID: 31526964
DOI: 10.1016/j.nut.2019.110558

Abstract

Objectives: Malnutrition is the most common complication of patients with esophageal cancer and can lead to poor prognosis and death. Good nutritional status has been shown to help improve patient outcomes and reduce complications. In the absence of specific evidence on the effect of nutrition in patients with esophageal cancer, the purpose of this study was to investigate the effect of whole-course nutrition management on the prognosis and complications of chemoradiotherapy in patients with esophageal cancer through a randomized controlled trial.

Methods: A total of 96 patients with esophageal cancer treated with concurrent chemoradiation were randomized to an intervention group (treated with whole-course nutrition management from the Nutrition Support Team) and a control group (treated with the general nutritional method) for approximately 6 wk. Dietary surveys and body measurements were conducted at baseline and every day thereafter. Patient-generated Subjective Global Assessment score, blood index, quality of life, and psychological condition were assessed at baseline and every week before discharge. Complications (e.g., radiation esophagitis, myelosuppression, and skin symptoms), completion rates of therapy, short-term efficacy evaluation, as well as clinical outcomes were measured.

Results: A total of 85 patients completed the study (intervention group = 45; control group = 40). There were significant differences in the changes of serum albumin and total protein between the two groups throughout the trial (P < 0.05). Complications (e.g., radioactive esophagitis, skin symptom of complications) and quality of life were statistically different before and after the intervention (P < 0.05). The difference in the change of other indicators was not statistically significant.

Conclusions: Whole-course nutrition management can improve the nutritional status of patients with esophageal cancer treated with concurrent chemoradiotherapy, reduce the severity of radiation esophagitis and radiation skin reactions, improve the quality of life, and relieve depressive symptoms.

Keywords: Complications; Concurrent chemoradiotherapy; Esophageal cancer; Nutrition support team; Nutritional status; Patient-generated Subjective Global Assessment.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Chemoradiotherapy*
Esophageal Neoplasms / complications
Esophageal Neoplasms / physiopathology
Esophageal Neoplasms / therapy*
Female
Humans
Male
Malnutrition / etiology
Malnutrition / therapy*
Middle Aged
Nutrition Therapy / methods*
Nutritional Status
Quality of Life
Treatment Outcome