Nutrition intervention is beneficial to the quality of life of patients with gastrointestinal cancer undergoing chemotherapy in Vietnam

Cancer Med. 2021 Mar;10(5):1668-1680. doi: 10.1002/cam4.3766. Epub 2021 Feb 7.

Abstract

Introduction: The best treatment therapy for gastrointestinal cancer patients is assessed by the improvement of health status and quality of life (QoL) after treatments. Malnutrition is related to loss of muscle strengths which leads to lower physical performance and emotional status. Thus, this study aimed to estimate the effects of nutritional interventions on the improvement of QoL among gastrointestinal patients undergoing chemotherapy in Vietnam.

Methods: A quasi-experiment with intervention and control groups for pre- and post-intervention assessment was carried out at the Department of Oncology and Palliative Care-Hanoi Medical University Hospital from 2016 to 2019. Sixty gastrointestinal cancer patients were recruited in each group. The intervention regimen consisted of nutritional counseling, a specific menu with a recommended amount of energy, protein, and formula milk used within 2 months. Nutritional status and QoL of patients were evaluated using The Scored Patient-Generated Subjective Global Assessment (PG-SGA) and The European Organization for Research and Treatment of Cancer (EORTC). The difference in differences (DiD) method was utilized to estimate the outcome between control and intervention groups.

Results: After the intervention, patients of the intervention group had better changes in scores of global health status (Coef =16.68; 95% CI =7.90; 25.46), physical (Coef =14.51; 95% CI =5.34; 23.70), and role functioning (Coef =14.67; 95% CI =1.63; 27.70) compared to the control group. Regarding symptom scales, the level of fatigue, pain, and insomnia symptoms significantly reduced between pre- and post-intervention in the intervention group. In addition, living in urban areas, defined as malnourished and having low prealbumin levels, were positively associated with the lower global health status/QoL score.

Conclusion: Nutritional therapy with high protein was beneficial to the improvement in QoL, physical function and the reduction of negative symptoms among gastrointestinal cancer patients. Early individualized nutritional support in consultation with professional dietitians during chemotherapy plays an integral part in enhancing the QoL and better treatment prognosis.

Clinical trial registration number: NCT04517708.

Keywords: digestive cancer; gastric cancer; nutrition; quality of life.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Cancer Pain / diet therapy
  • Colonic Neoplasms / complications
  • Colonic Neoplasms / drug therapy*
  • Colonic Neoplasms / psychology
  • Dietary Proteins / administration & dosage
  • Energy Intake
  • Fatigue / diet therapy
  • Female
  • Food, Formulated
  • Health Status*
  • Humans
  • Male
  • Malnutrition / diet therapy*
  • Malnutrition / etiology
  • Middle Aged
  • Milk
  • Nutrition Assessment
  • Nutritional Status
  • Physical Functional Performance
  • Quality of Life*
  • Sleep Initiation and Maintenance Disorders / diet therapy
  • Socioeconomic Factors
  • Stomach Neoplasms / complications
  • Stomach Neoplasms / drug therapy*
  • Stomach Neoplasms / psychology
  • Treatment Outcome
  • Vietnam

Substances

  • Dietary Proteins

Associated data

  • ClinicalTrials.gov/NCT04517708