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Supportive Care in Cancer

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01-01-2016 | Review Article

Nutrition intervention approaches to reduce malnutrition in oncology patients: a systematic review

Authors: Jia Li Charmaine Lee, Lai Peng Leong, Su Lin Lim

Published in: Supportive Care in Cancer | Issue 1/2016

Abstract

Purpose

Malnutrition is a very common problem in oncology patients and is associated with many negative consequences including poorer prognosis, quality of life and survival. However, malnutrition in oncology patients is often overlooked although there is growing evidence showing that it can be prevented or reduced through nutrition intervention. This paper aims to provide an updated review on the effectiveness of different nutrition intervention approaches on nutrition status outcomes in oncology patients.

Methods

Randomised controlled trials (RCTs) published between 1994 and 2014 which examined the effects of nutrition intervention approaches—in particular, nutrition counselling (NC), oral nutrition supplements (ONS) and tube feeding (TF)—on nutrition status outcomes of oncology patients were identified and reviewed.

Results

Thirteen papers from 11 RCTs with a total of 1077 participants were included. The intervention approaches included NC (four studies), NC + ONS (five studies), ONS (three studies) and TF (three studies). The various results suggest that NC with or without ONS was associated with consistent improvements in several nutrition status outcomes. On the other hand, ONS and TF were associated with inconsistent improvements in few aspects of nutrition status outcomes.

Conclusions

The referral of oncology patients for NC is recommended given the strong evidence of its beneficial effects on the prevention and reduction of malnutrition. Other forms of nutrition support including ONS and TF may then be included if deemed suitable and necessary for the individual.

Quality of life (QoL) of patients is assessed using questionnaires with different items such as physical, emotional and social function as well as patient symptoms [15].

Patient-generated subjective global assessment (PG-SGA) is a nutrition status assessment tool based on the dietary intake, weight change, functional capacity, symptoms and physical examination that has been validated for use on cancer patients. After the assessment, patients are classified as well-nourished (A), moderately malnourished (B) and severely malnourished (C) [20]. A numerical PG-SGA score is also given, with higher scores indicating poorer nutrition status [12].

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Title: Nutrition intervention approaches to reduce malnutrition in oncology patients: a systematic review
Authors: Jia Li Charmaine Lee
Lai Peng Leong
Su Lin Lim
Publication date: 01-01-2016
Publisher: Springer Berlin Heidelberg
Published in: Supportive Care in Cancer / Issue 1/2016
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-015-2958-4

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