| Added by | mollevi |
|---|---|
| Last modified by | celine.gongora |
| Group name | EquipeCG |
| Item Type | Journal Article |
| Title | Nutritional advice in older patients at risk of malnutrition during treatment for chemotherapy: a two-year randomized controlled trial |
| Creator | Bourdel-Marchasson et al. |
| Author | I. Bourdel-Marchasson |
| Author | C. Blanc-Bisson |
| Author | A. Doussau |
| Author | C. Germain |
| Author | J. F. Blanc |
| Author | J. Dauba |
| Author | C. Lahmar |
| Author | E. Terrebonne |
| Author | C. Lecaille |
| Author | J. Ceccaldi |
| Author | L. Cany |
| Author | S. Lavau-Denes |
| Author | N. Houede |
| Author | F. Chomy |
| Author | J. Durrieu |
| Author | P. Soubeyran |
| Author | P. Senesse |
| Author | G. Chene |
| Author | M. Fonck |
| Abstract | OBJECTIVE: 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. METHOD: We conducted a multicentre, open-label interventional, stratified (centre), parallel randomised controlled trial, with a 1ratio1 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. RESULTS: 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<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. CONCLUSION: 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. TRIAL REGISTRATION: ClinicalTrials.gov NCT00459589. |
| Publication | PloS One |
| Volume | 9 |
| Pages | e108687 |
| Date | 2014 |
| DOI | 10.1371/journal.pone.0108687 |
| ISSN | 1932-6203 (Electronic) 1932-6203 (Linking) |
| Tags | clinic |
| Date Added | 2018/07/20 - 10:05:58 |
| Date Modified | 2019/05/14 - 13:56:16 |
| Notes and Attachments | (Note) (Note) 25265392 (Attachment) |
Institut de Recherche en Cancérologie de
