Early 7-day supplemental parenteral nutrition improves body composition and muscle strength in hypophagic cancer patients at nutritional risk

Caccialanza, Riccardo; Cereda, Emanuele; Caraccia, Marilisa; Klersy, Catherine; Nardi, Mariateresa; Cappello, Silvia; Borioli, Valeria; Turri, Annalisa; Imarisio, Ilaria; Lasagna, Angioletta; Saddi, Jessica; Arcaini, Luca; Benazzo, Marco; Stragliotto, Silvia; Zagonel, Vittorina; Pedrazzoli, Paolo

doi:10.1007/s00520-018-4527-0

Cited by 40 publications

(40 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Two recent prospective studies have investigated the effects of PN in cancer patients receiving chemoradiotherapy using also BIVA [78,79]. Early 7-day supplemental PN resulted in significantly improved phase angle, handgrip strength, and serum prealbumin levels in 118 hypophagic and hospitalized cancer patients at nutritional risk [78].…”

Section: Parenteral Nutritionmentioning

confidence: 99%

Nutritional Therapy in Cancer Patients Receiving Chemoradiotherapy: Should We Need Stronger Recommendations to Act for Improving Outcomes?

Cotogni¹,

Pedrazzoli²,

Waele³

et al. 2019

J. Cancer

Self Cite

View full text Add to dashboard Cite

One of the challenges during chemotherapy and radiotherapy is to complete the planned cycles and doses without dose-limiting toxicity. Growing evidence clearly demonstrates the relationship between dose-limiting toxicity and low muscle mass. Moreover, malnutrition leads to low performance status, impaired quality of life, unplanned hospital admissions, and reduced survival. In the past, the lack of clear and authoritative recommendations and guidelines has meant that oncologists have not always fully appreciated the importance of nutritional therapy in patients receiving anticancer treatments. Therefore, collaboration between oncologists and clinical nutrition specialists needs to be urgently improved. Recent guidelines from scientific societies and practical recommendations by inter-society consensus documents can be summarized as follows: 1) timely nutritional therapy should be carefully considered if patients undergoing anticancer treatments are malnourished or at risk of malnutrition due to inadequate oral intake; 2) if oral intake is inadequate despite counseling and oral nutritional supplements, supplemental enteral nutrition or, if this is not sufficient or feasible, parenteral nutrition should be considered; 3) home artificial nutrition should be prescribed and regularly monitored using defined protocols developed between oncologists and clinical nutrition specialists; 4) appropriate nutritional management in the context of simultaneous care should become a guaranteed right for all patients with cancer. The purpose of this review is to provide oncologists with an overview of the aims and current evidence about nutrition in oncology, together with updated practical and concise recommendations on the application of nutritional therapy in cancer patients receiving chemoradiotherapy.

show abstract

Section: Parenteral Nutritionmentioning

confidence: 99%

Nutritional Therapy in Cancer Patients Receiving Chemoradiotherapy: Should We Need Stronger Recommendations to Act for Improving Outcomes?

Cotogni¹,

Pedrazzoli²,

Waele³

et al. 2019

J. Cancer

Self Cite

View full text Add to dashboard Cite

show abstract

“…The following are available online at , Table S1. Excluded Studies [ 15 , 16 , 33 , 34 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 ], and Table S2. Quality assessment of the selected studies by the Jadad Scale.…”

mentioning

confidence: 99%

Effect of Supplemental Parenteral Nutrition Versus Enteral Nutrition Alone on Clinical Outcomes in Critically Ill Adult Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Alsharif

Aljuraiban

et al. 2020

Nutrients

View full text Add to dashboard Cite

Enteral nutrition (EN) is considered the first feeding route for critically ill patients. However, adverse effects such as gastrointestinal complications limit its optimal provision, leading to inadequate energy and protein intake. We compared the clinical outcomes of supplemental parenteral nutrition added to EN (SPN + EN) and EN alone in critically ill adults. Electronic databases restricted to full-text randomized controlled trials available in the English language and published from January 1990 to January 2019 were searched. The risk of bias was evaluated using the Jadad scale, and the meta-analysis was conducted using the MedCalc software. A total of five studies were eligible for inclusion in the systematic review and meta-analysis. Compared to EN alone, SPN + EN decreased the risk of nosocomial infections (relative risk (RR) = 0.733, p = 0.032) and intensive care unit (ICU) mortality (RR = 0.569, p = 0.030). No significant differences were observed between SPN + EN and EN in the length of hospital stay, hospital mortality, length of ICU stay, and duration of mechanical ventilation. In conclusion, when enteral feeding fails to fulfill the energy requirements in critically ill adult patients, SPN may be beneficial as it helps in decreasing nosocomial infections and ICU mortality, in addition to increasing energy and protein intakes with no negative effects on other clinical outcomes.

show abstract

“…History of unintentional WL in the previous 6 months was obtained retrospectively. Phase angle, SPA, and FFMI were assessed by BIVA (NutriLAB, Akern/RJL) according to standard procedures and muscle strength was measured by digital hand dynamometry (handgrip strength [HG]; DynEx™, Akern/MD Systems).…”

Section: Methodsmentioning

confidence: 99%

“…A major issue in daily practice is the availability of accurate and noninvasive technologies to evaluate and monitor the efficacy of nutritional interventions. The use of measured bioelectrical parameter, such as phase angle (PhA), using bioelectrical impedance vector analysis (BIVA), was demonstrated to reliably reflect cell integrity and energy balance in patients with chronic diseases . In addition, BIVA appears to be an accurate procedure to evaluate the body composition, since it is independent of the hydration status .…”

Section: Introductionmentioning

confidence: 99%

“…The use of measured bioelectrical parameter, such as phase angle (PhA), using bioelectrical impedance vector analysis (BIVA), was demonstrated to reliably reflect cell integrity 25 and energy balance in patients with chronic diseases. 26,27 In addition, BIVA appears to be an accurate procedure to evaluate the body composition, since it is independent of the hydration status. 25 Several studies have shown that PhA and standardized PhA (SPA) can predict prognosis in different cancer populations 28 and that PhA is a reliable marker for the detection of sarcopenia in cancer patients.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Whey protein isolate supplementation improves body composition, muscle strength, and treatment tolerance in malnourished advanced cancer patients undergoing chemotherapy

et al. 2019

Self Cite

View full text Add to dashboard Cite

In recent years, whey proteins (WP) have attracted increasing attention in health and disease for their bioactive functions. The aim of this study was to evaluate the benefit of WP isolate (WPI) supplementation in addition to nutritional counseling in malnourished advanced cancer patients undergoing chemotherapy (CT). In a single‐center, randomized, pragmatic, and parallel‐group controlled trial (http://www.ClinicalTrials.gov: NCT02065726), 166 malnourished advanced cancer patients with mixed tumor entities candidate to or undergoing CT were randomly assigned to receive nutritional counseling with (N = 82) or without (N = 84) WPI supplementation (20 g/d) for 3 months. The primary endpoint was the change in phase angle (PhA). Secondary endpoints included changes in standardized PhA (SPA), fat‐free mass index (FFMI), body weight, muscle strength, and CT toxicity (CTCAE 4.0 events). In patients with the primary endpoint assessed (modified intention‐to‐treat population), counseling plus WPI (N = 66) resulted in improved PhA compared to nutritional counseling alone (N = 69): mean difference, 0.48° (95% CI, 0.05 to 0.90) (P = .027). WPI supplementation also resulted in improved SPA (P = .021), FFMI (P = .041), body weight (P = .023), muscle strength (P < .001), and in a reduced risk of CT toxicity (risk difference, −9.8% [95% CI, −16.9 to −2.6]; P = .009), particularly of severe (grade ≥ 3) events (risk difference, −30.4% [95% CI, −44.4 to −16.5]; P = .001). In malnourished advanced cancer patients undergoing CT, receiving nutritional counseling, a 3‐month supplementation with WPI resulted in improved body composition, muscle strength, body weight, and reduced CT toxicity. Further trials, aimed at verifying the efficacy of this nutritional intervention on mid‐ and long‐term primary clinical endpoints in newly diagnosed specific cancer types, are warranted.

show abstract

Early 7-day supplemental parenteral nutrition improves body composition and muscle strength in hypophagic cancer patients at nutritional risk

Cited by 40 publications

References 46 publications

Nutritional Therapy in Cancer Patients Receiving Chemoradiotherapy: Should We Need Stronger Recommendations to Act for Improving Outcomes?

Nutritional Therapy in Cancer Patients Receiving Chemoradiotherapy: Should We Need Stronger Recommendations to Act for Improving Outcomes?

Effect of Supplemental Parenteral Nutrition Versus Enteral Nutrition Alone on Clinical Outcomes in Critically Ill Adult Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Whey protein isolate supplementation improves body composition, muscle strength, and treatment tolerance in malnourished advanced cancer patients undergoing chemotherapy

Contact Info

Product

Resources

About