The effect of dietary counselling and/or oral supplements in lung cancer patients undergoing chemotherapy and/or radiotherapy: A systematic review (#847)
Aim: The prevalence of malnutrition in lung cancer patients at various stages of disease and treatment ranges from 45 to 69%, with a median weight loss of 6.5% reported compared to usual weight. This systematic review examined if dietary counselling (DC) and/or oral supplements (OS) during chemotherapy and/or radiotherapy in patients with lung cancer affect nutritional status, functional status, quality of life (QoL) or treatment outcomes.
Methods: Relevant studies up to March 2012 were identified from the following databases: Medline, PubMed, CINAHL, Web of Science and the Cochrane Library. Search terms included: ‘lung neoplasms’ OR ‘lung cancer’ AND ‘nutrition’ OR ‘nutrition support’ OR ‘dietary counselling’ OR ‘diet therapy’ OR ‘nutrition therapy.’ Articles meeting pre-determined inclusion/exclusion criteria were critically appraised and included in the review.
Results: Five studies were identified including three randomised controlled trials (RCT’s), one historical cohort and one case series. DC consistently improved dietary energy and protein intake during chemotherapy and radiotherapy. Some low level evidence suggests DC or OS may reduce weight loss and maintain nutritional status during radiotherapy treatment. Evidence of an effect on QoL and functional status is limited, and no evidence was located for treatment response or survival during radiotherapy. DC or OS during chemotherapy had no effect on weight changes, nutritional status, QoL, treatment response or survival, with no evidence located for an effect on functional status.
Conclusion: Dietary counselling improves energy and protein intake during chemotherapy and radiotherapy in patients with lung cancer. Current evidence suggests no benefit to other outcomes during chemotherapy. There is insufficient evidence regarding the effect on other outcomes during radiotherapy. All studies were conducted in multiple tumour groups and only two studies analysed data from lung cancer patients separately. Randomised controlled trials examining the effect of DC in patients with lung cancer during radiotherapy treatment are required.