Effects of medical nutrition therapy compared with general nutritional advice on nutritional status and nutrition-related complications in esophageal cancer patients receiving concurrent chemoradiation: A randomized controlled trial

Article type: Research Article

Authors: Movahed, Sara^{a; c} | Seilanian Toussi, Mehdi^b | Pahlavani, Naseh^{a; c} | Motlagh, Ali Ghanbari^d | Eslami, Saeid^e | Nematy, Mohsen^a | Ghayour-Mobarhan, Majid^f | Khadem-Rezaiyan, Majid^g | Emadzadeh, Maryam^h | Varshoee Tabrizi, Fatemehⁱ | Bozzetti, Federico^j | Norouzy, Abdolreza^{a; *}

Affiliations: [a] Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran | [b] Cancer Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran | [c] Students Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran | [d] Department of Radiotherapy Oncology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran | [e] Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran | [f] Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran | [g] Clinical Research Development Unit, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran | [h] Clinical Research Unit, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran | [i] Reza Radiotherapy and Oncology Center, Mashhad, Iran | [j] Faculty of Medicine, University of Milan, Lombardia, Italy

Correspondence: [*] Corresponding author: Abdolreza Norouzy, Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran, Address: Department of Nutrition, Faculty of Medicine, Paradise Daneshghah, Azadi Square, Mashhad, PO Box: 917794-8564, Iran. Tel.: +985138002382; E-mail: [email protected].

Abstract: OBJECTIVE:The purpose of this randomized controlled trial study was to assess the effects of medical nutrition therapy (MNT) compared with general nutritional advice (NA) on nutritional status in esophageal cancer (EC) patients during Chemoradiation (CRT). METHOD:The sample includes one hundred newly diagnosed patients with EC. The MNT group received individualized nutritional therapy. The NA group received general nutritional advice at the beginning of the participation. Patient-Generated- Subjective Global Assessment (PG-SGA), anthropometric indices, body composition, dietary intake, laboratory tests, and nutrition-related complications were assessed. RESULTS:Forty-nine cases were in the MNT group. The MNT group had significantly more favorable energy (26.4±14.1 vs. 18.2±11.2 kcal/kgw.day) and protein (1±0.6 vs. 0.7±0.4 g/kgw.day) intake than the NA group at the final evaluation. The PG-SGA score diminished but not significantly in both groups (11±6 vs. 12±6). As compared to the NA group, patients in the MNT group experienced more frequently no weight loss (21% vs. 11%) or mild weight loss (40% vs 35%) during the treatment. Meanwhile, moderate weight loss was more frequently observed in the NA group (26% vs. 44%). In the MNT group, those with severe weight loss had not proper adherence to the nutritional protocol. Mid-upper arm circumference, body composition, laboratory tests, physical performance, and nutrition-related complications were not significantly different between the two groups. CONCLUSION:As compared to general NA, MNT improved energy and macronutrients intake in patients with EC undergoing CRT which resulted in less severe weight loss and potentially better nutritional status.

Keywords: Esophageal cancer, nutritional assessment, medical nutrition therapy, nutritional advice, randomized controlled trial

DOI: 10.3233/MNM-200424

Journal: Mediterranean Journal of Nutrition and Metabolism, vol. 13, no. 3, pp. 265-276, 2020