title: Simple nutritional intervention in patients with advanced cancers of the gastrointestinal tract, non-small cell lung cancers or mesothelioma and weight loss receiving chemotherapy: a randomised controlled trial.
abstract: BACKGROUND
  Weight loss in patients with cancer is common and associated with a poorer survival and quality of life. Benefits from nutritional interventions are unclear. The present study assessed the effect of dietary advice and/or oral nutritional supplements on survival, nutritional endpoints and quality of life in patients with weight loss receiving palliative chemotherapy for gastrointestinal and non-small cell lung cancers or mesothelioma.
  
  
  METHODS
  Participants were randomly assigned to receive no intervention, dietary advice, a nutritional supplement or dietary advice plus supplement before the start of chemotherapy. Patients were followed for 1 year. Survival, nutritional status and quality of life were assessed.
  
  
  RESULTS
  In total, 256 men and 102 women (median age, 66 years; range 24-88 years) with gastrointestinal (n = 277) and lung (n = 81) cancers were recruited. Median (range) follow-up was 6 (0-49) months. One-year survival was 38.6% (95% confidence interval 33.3-43.9). No differences in survival, weight or quality of life between groups were seen. Patients surviving beyond 26 weeks experienced significant weight gain from baseline to 12 weeks, although this was independent of nutritional intervention.
  
  
  CONCLUSIONS
  Simple nutritional interventions did not improve clinical or nutritional outcomes or quality of life. Weight gain predicted a longer survival but occurred independently of nutritional intervention.
authors: Department of Medicine Royal Marsden Hospital, London and Sutton, UK.
authors: C
authors: C
authors: Baldwin
authors: A
authors: A
authors: Spiro
authors: C
authors: C
authors: McGough
authors: A R
authors: AR
authors: Norman
authors: A
authors: A
authors: Gillbanks
authors: K
authors: K
authors: Thomas
authors: D
authors: D
authors: Cunningham
authors: M
authors: M
authors: O'Brien
authors: H J N
authors: HJ
authors: Andreyev
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000178:diet therapy* / Q000188:drug therapy; D016001:Confidence Intervals; D019587:Dietary Supplements; D004046:Dietetics; D023381:Endpoint Determination; D005260:Female; D005500:Follow-Up Studies; D005770:Gastrointestinal Neoplasms / Q000178:diet therapy* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008654:Mesothelioma / Q000178:diet therapy* / Q000188:drug therapy; D008875:Middle Aged; D009752:Nutritional Status / Q000187:drug effects*; D010166:Palliative Care / Q000379:methods*; D011446:Prospective Studies; D011788:Quality of Life; D015430:Weight Gain / Q000187:drug effects; D015431:Weight Loss / Q000187:drug effects; D055815:Young Adult