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

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Abstract

Purpose

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.

Methods

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.

Results

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 < 0.001) and at 26 weeks (28.4 (21.3, 35.4) adjusted for baseline, p < 0.001). Nutritional risk score was lower (p < 0.001), and loss of body weight attenuated (p < 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 < 0.001).

Conclusions

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.

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Acknowledgments

The authors would like to thank (1) Liang Low, Paul Cashin, John Gribbin and the Upper Gastrointestinal consultants of Monash Health for their contribution to recruiting patients to this study; (2) Carmen Puskas for data entry; (3) Southern Melbourne Integrated Cancer Service for funding.

Conflict of interest

None of the authors have a conflict of interest to declare. This work was funded by Southern Melbourne Integrated Cancer Service (SMICS).

Author information

Authors and Affiliations

  1. Department of Dietetics, Monash Health, Monash Medical Centre, 246 Clayton Rd, Clayton, Victoria, 3168, Australia

    Mary Anne Silvers & June Savva

  2. Allied Health Research Unit, Monash Health, Monash Medical Centre, Clayton, Victoria, Australia

    Catherine E. Huggins, Helen Truby & Terry Haines

  3. Department of Nutrition and Dietetics, Monash University, Clayton, Victoria, Australia

    Catherine E. Huggins & Helen Truby

  4. Department of Physiotherapy, Monash University, Clayton, Victoria, Australia

    Terry Haines

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  1. Mary Anne Silvers
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  2. June Savva
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Corresponding author

Correspondence to Mary Anne Silvers.

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All authors have made substantial contributions and final approval of the conceptions, drafting and final version.

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Silvers, M.A., Savva, J., Huggins, C.E. et al. Potential benefits of early nutritional intervention in adults with upper gastrointestinal cancer: a pilot randomised trial. Support Care Cancer 22, 3035–3044 (2014). https://doi.org/10.1007/s00520-014-2311-3

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  • DOI: https://doi.org/10.1007/s00520-014-2311-3

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