An Interdisciplinary Nutrition Support Team Improves Clinical and Hospitalized Outcomes of Esophageal Cancer Patients with Concurrent Chemoradiotherapy

Abstract

Background:The prevalence of malnutrition is very high in patients with cancer. The purpose of this study was to investigate whether or not a nutrition support team (NST) could benefit esophageal cancer patients undergoing chemoradiotherapy (CRT).Methods:Between June 2012 and April 2014, 50 esophageal cancer patients undergoing concurrent CRT were randomly assigned into two groups: The NST group and the control group. The nutritional statuses of 25 patients in the NST group were managed by the NST. The other 25 patients in the control group underwent the supervision of radiotherapy practitioners. At the end of the CRT, nutritional status, the incidence of complications, and completion rate of radiotherapy were evaluated. Besides, the length of hospital stay (LOS) and the in-patient cost were also compared between these two groups.Results:At the completion of CRF, the nutritional status in the NST group were much better than those in the control group, as evidenced by prealbumin (ALB), transferrin, and ALB parameters (P = 0.001, 0.000, and 0.000, respectively). The complication incidences, including bone marrow suppression (20% vs. 48%, P = 0.037) and complications related infections (12% vs. 44%, P = 0.012), in the NST group were lower and significantly different from the control group. In addition, only one patient in the NST group did not complete the planned radiotherapy while 6 patients in the control group had interrupted or delayed radiotherapy (96% vs. 76%, P = 0.103). Furthermore, the average LOS was decreased by 4.5 days (P = 0.001) and in-patient cost was reduced to 1.26 ± 0.75 thousand US dollars person-times (P > 0.05) in the NST group.Conclusions:A NST could provide positive effects in esophageal cancer patients during concurrent CRT on maintaining their nutrition status and improving the compliance of CRF. Moreover, the NST could be helpful on reducing LOS and in-patient costs.

Effects of nutritional support on short-term clinical outcomes and immune response in unresectable locally advanced oesophageal squamous cell carcinoma

“…However, the nutritional support group had a significantly lower incidence of severe and total neutropenia compared with the routine care group (p = .042 and.007 respectively). Cong and his co-workers also reported a significant difference in the percentage of patients who experienced grade ≥2 bone marrow suppression (20% and 48% in the nutritional support group and the control group, p = .037; Cong et al, 2015). Immune analysis in our study also showed that nutritional support was effective in helping the immune system during CCRT (as shown in Table 6).…”

“…Cong and his co-workers also reported a significant difference in the percentage of patients who experienced grade ≥2 bone marrow suppression (20% and 48% in the nutritional support group and the control group, p = .037; Cong et al, 2015). However, the nutritional support group had a significantly lower incidence of severe and total neutropenia compared with the routine care group (p = .042 and.007 respectively).…”

“…In a small-sample prospective randomised study conducted by Cong et al, 50 patients with oesophageal cancer who received CCRT were randomly assigned into a nutrition support team group and a control group. Their results revealed that the completion rate in the control group was 76% (19/25; Cong et al, 2015).…”

Nutritional Management of Esophageal Cancer Patients

“…Nutritional intervention was also associated with a lower average length of hospital stay and in-patient cost [111]. Furthermore, nutritional intervention improved survival of esophageal cancer patients treated with definitive chemoradiotherapy.…”

Eksplorasi Peran Perawat Dan Ahli Gizi Dalam Pemberian Nutrisi Pada Pasien Kritis

“…Dukungan nutrisi meliputi terapi obat, perawatan, diet dan peran interdisipliner diantaranya dokter, apoteker, ahli gizi dan perawat (Cong et al, 2015;Maree, 2011). Dukungan nutrisi merupakan tugas penting dalam perawatan pasien kritis.…”