Nutritional advice in older patients at risk of malnutrition during treatment for chemotherapy: a two-year randomized controlled trial

We tested the effect of dietary advice dedicated to increase intake in older patients at risk for malnutrition during chemotherapy, versus usual care, on one-year mortality. We conducted a multicentre, open-label interventional, stratified (centre), parallel randomised controlled trial, with a 1∶1 r...

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Published in:PloS one 2014-09, Vol.9 (9), p.e108687
Main Authors: Bourdel-Marchasson, Isabelle, Blanc-Bisson, Christelle, Doussau, Adélaïde, Germain, Christine, Blanc, Jean-Frédéric, Dauba, Jérôme, Lahmar, Cyril, Terrebonne, Eric, Lecaille, Cédric, Ceccaldi, Joël, Cany, Laurent, Lavau-Denes, Sandrine, Houede, Nadine, Chomy, François, Durrieu, Jessica, Soubeyran, Pierre, Senesse, Pierre, Chene, Geneviève, Fonck, Mariane
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Antineoplastic Agents - adverse effects
Antineoplastic Agents - therapeutic use
Biology and Life Sciences
Body weight
Cachexia
Cancer
Cancer therapies
Care and treatment
Cell cycle
Chemotherapy
Clinical trials
Colon
Colorectal cancer
Counseling
Diet
Dietary intake
Elderly patients
Energy Intake
Female
Gerontology
Health aspects
Humans
Intervention
Life Sciences
Lungs
Lymphoma
Lymphomas
Male
Malnutrition
Malnutrition - mortality
Medical prognosis
Medicine and Health Sciences
Mortality
Neoplasms - drug therapy
Neoplasms - mortality
Nutrition assessment
Nutrition research
Nutritional assessment
Nutritional Status
Pancreas
Patient satisfaction
Patients
Quality of life
Radiation therapy
Randomization
Risk
Sarcopenia
Solid tumors
Toxicity
Weight Loss
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cited_by cdi_FETCH-LOGICAL-c792t-88be01fc86b5c5b904a8ddb2246bf2c79271c0e448efaea84e91a9fc54838dbb3
cites cdi_FETCH-LOGICAL-c792t-88be01fc86b5c5b904a8ddb2246bf2c79271c0e448efaea84e91a9fc54838dbb3
container_end_page
container_issue 9
container_start_page e108687
container_title PloS one
container_volume 9
creator Bourdel-Marchasson, Isabelle
Blanc-Bisson, Christelle
Doussau, Adélaïde
Germain, Christine
Blanc, Jean-Frédéric
Dauba, Jérôme
Lahmar, Cyril
Terrebonne, Eric
Lecaille, Cédric
Ceccaldi, Joël
Cany, Laurent
Lavau-Denes, Sandrine
Houede, Nadine
Chomy, François
Durrieu, Jessica
Soubeyran, Pierre
Senesse, Pierre
Chene, Geneviève
Fonck, Mariane
description We tested the effect of dietary advice dedicated to increase intake in older patients at risk for malnutrition during chemotherapy, versus usual care, on one-year mortality. We conducted a multicentre, open-label interventional, stratified (centre), parallel randomised controlled trial, with a 1∶1 ratio, with two-year follow-up. Patients were aged 70 years or older treated with chemotherapy for solid tumour and at risk of malnutrition (MNA, Mini Nutritional Assessment 17-23.5). Intervention consisted of diet counselling with the aim of achieving an energy intake of 30 kCal/kg body weight/d and 1.2 g protein/kg/d, by face-to-face discussion targeting the main nutritional symptoms, compared to usual care. Interviews were performed 6 times during the chemotherapy sessions for 3 to 6 months. The primary endpoint was 1-year mortality and secondary endpoints were 2-year mortality, toxicities and chemotherapy outcomes. Between April 2007 and March 2010 we randomised 341 patients and 336 were analysed: mean (standard deviation) age of 78.0 y (4·9), 51.2% male, mean MNA 20.2 (2.1). Distribution of cancer types was similar in the two groups; the most frequent were colon (22.4%), lymphoma (14.9%), lung (10.4%), and pancreas (17.0%). Both groups increased their dietary intake, but to a larger extent with intervention (p
doi_str_mv 10.1371/journal.pone.0108687
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Distribution of cancer types was similar in the two groups; the most frequent were colon (22.4%), lymphoma (14.9%), lung (10.4%), and pancreas (17.0%). Both groups increased their dietary intake, but to a larger extent with intervention (p&lt;0.01). At the second visit, the energy target was achieved in 57 (40.4%) patients and the protein target in 66 (46.8%) with the intervention compared respectively to 13 (13.5%) and 20 (20.8%) in the controls. Death occurred during the first year in 143 patients (42.56%), without difference according to the intervention (p = 0.79). No difference in nutritional status changes was found. Response to chemotherapy was also similar between the groups. Early dietary counselling was efficient in increasing intake but had no beneficial effect on mortality or secondary outcomes. Cancer cachexia antianabolism may explain this lack of effect. 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Database</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>Advanced Technologies &amp; Aerospace Database</collection><collection>ProQuest Advanced Technologies &amp; Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials science collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>Hyper Article en Ligne (HAL)</collection><collection>Hyper Article en Ligne (HAL) (Open Access)</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bourdel-Marchasson, Isabelle</au><au>Blanc-Bisson, Christelle</au><au>Doussau, Adélaïde</au><au>Germain, Christine</au><au>Blanc, Jean-Frédéric</au><au>Dauba, Jérôme</au><au>Lahmar, Cyril</au><au>Terrebonne, Eric</au><au>Lecaille, Cédric</au><au>Ceccaldi, Joël</au><au>Cany, Laurent</au><au>Lavau-Denes, Sandrine</au><au>Houede, Nadine</au><au>Chomy, François</au><au>Durrieu, Jessica</au><au>Soubeyran, Pierre</au><au>Senesse, Pierre</au><au>Chene, Geneviève</au><au>Fonck, Mariane</au><au>Wong, Vincent</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Nutritional advice in older patients at risk of malnutrition during treatment for chemotherapy: a two-year randomized controlled trial</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2014-09-29</date><risdate>2014</risdate><volume>9</volume><issue>9</issue><spage>e108687</spage><pages>e108687-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>We tested the effect of dietary advice dedicated to increase intake in older patients at risk for malnutrition during chemotherapy, versus usual care, on one-year mortality. We conducted a multicentre, open-label interventional, stratified (centre), parallel randomised controlled trial, with a 1∶1 ratio, with two-year follow-up. Patients were aged 70 years or older treated with chemotherapy for solid tumour and at risk of malnutrition (MNA, Mini Nutritional Assessment 17-23.5). Intervention consisted of diet counselling with the aim of achieving an energy intake of 30 kCal/kg body weight/d and 1.2 g protein/kg/d, by face-to-face discussion targeting the main nutritional symptoms, compared to usual care. Interviews were performed 6 times during the chemotherapy sessions for 3 to 6 months. The primary endpoint was 1-year mortality and secondary endpoints were 2-year mortality, toxicities and chemotherapy outcomes. Between April 2007 and March 2010 we randomised 341 patients and 336 were analysed: mean (standard deviation) age of 78.0 y (4·9), 51.2% male, mean MNA 20.2 (2.1). Distribution of cancer types was similar in the two groups; the most frequent were colon (22.4%), lymphoma (14.9%), lung (10.4%), and pancreas (17.0%). Both groups increased their dietary intake, but to a larger extent with intervention (p&lt;0.01). At the second visit, the energy target was achieved in 57 (40.4%) patients and the protein target in 66 (46.8%) with the intervention compared respectively to 13 (13.5%) and 20 (20.8%) in the controls. Death occurred during the first year in 143 patients (42.56%), without difference according to the intervention (p = 0.79). No difference in nutritional status changes was found. Response to chemotherapy was also similar between the groups. Early dietary counselling was efficient in increasing intake but had no beneficial effect on mortality or secondary outcomes. Cancer cachexia antianabolism may explain this lack of effect. ClinicalTrials.gov NCT00459589.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>25265392</pmid><doi>10.1371/journal.pone.0108687</doi><orcidid>https://orcid.org/0000-0003-3542-2898</orcidid><orcidid>https://orcid.org/0000-0002-8852-5754</orcidid><oa>free_for_read</oa></addata></record>
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identifier ISSN: 1932-6203
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issn 1932-6203
1932-6203
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source Publicly Available Content Database; PubMed Central
subjects Aged
Aged, 80 and over
Antineoplastic Agents - adverse effects
Antineoplastic Agents - therapeutic use
Biology and Life Sciences
Body weight
Cachexia
Cancer
Cancer therapies
Care and treatment
Cell cycle
Chemotherapy
Clinical trials
Colon
Colorectal cancer
Counseling
Diet
Dietary intake
Elderly patients
Energy Intake
Female
Gerontology
Health aspects
Humans
Intervention
Life Sciences
Lungs
Lymphoma
Lymphomas
Male
Malnutrition
Malnutrition - mortality
Medical prognosis
Medicine and Health Sciences
Mortality
Neoplasms - drug therapy
Neoplasms - mortality
Nutrition assessment
Nutrition research
Nutritional assessment
Nutritional Status
Pancreas
Patient satisfaction
Patients
Quality of life
Radiation therapy
Randomization
Risk
Sarcopenia
Solid tumors
Toxicity
Weight Loss
title Nutritional advice in older patients at risk of malnutrition during treatment for chemotherapy: a two-year randomized controlled trial
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