Ovesen L, Allingstrup L, Hannibal J, Mortensen E L, Hansen O P
Department of Medicine P, Bispebjerg University Hospital, Copenhagen, Denmark.
J Clin Oncol. 1993 Oct;11(10):2043-9. doi: 10.1200/JCO.1993.11.10.2043.
This study examined the effect of frequent nutritional counseling on oral intake, body weight, response rate, survival, and quality of life in patients with cancer of the lung (small-cell), ovary, or breast undergoing cyclic chemotherapy.
Of 105 assessable patients, 57 were randomized to receive nutritional counseling, and 48 to receive no nutritional counseling and consumption of an ad lib oral intake. The intervention group was counseled to achieve a daily energy and protein intake according to recommended dietary allowances. Counseling was standardized and performed by a trained dietitian, and took place twice monthly during a 5-month period from start of chemotherapy.
Dietary counseling increased daily energy intake by approximately 1 MJ and protein intake by 10 g over the entire study period. There was no change in the control group. Counseling led to an insignificant increase in body weight, but triceps skinfold measurement increased significantly after 5 months. Response rate and overall survival did not differ between the groups. Quality of life measured by the Quality-of-Life index (QL-index) increased significantly in both groups, but did not differ between groups.
No clinical benefit could be demonstrated despite long-term and continuous improved food intake in cancer patients with solid tumors undergoing aggressive chemotherapy.
本研究探讨了频繁的营养咨询对接受周期性化疗的肺癌(小细胞癌)、卵巢癌或乳腺癌患者的口服摄入量、体重、缓解率、生存率和生活质量的影响。
在105例可评估患者中,57例被随机分配接受营养咨询,48例不接受营养咨询,自由口服摄入。干预组接受咨询,以根据推荐膳食摄入量实现每日能量和蛋白质摄入。咨询由一名经过培训的营养师标准化进行,从化疗开始后的5个月内每月进行两次。
在整个研究期间,饮食咨询使每日能量摄入增加约1兆焦耳,蛋白质摄入增加10克。对照组没有变化。咨询导致体重有不显著的增加,但5个月后三头肌皮褶厚度测量显著增加。两组之间的缓解率和总生存率没有差异。用生活质量指数(QL指数)测量的生活质量在两组中均显著提高,但组间没有差异。
尽管接受积极化疗的实体瘤癌症患者长期持续改善食物摄入量,但未显示出临床益处。