title: Nutritional support in patients with colorectal cancer during chemotherapy: does it work?
abstract: OBJECTIVE
  Early intervention with nutritional supplementation has been shown to halt malnutrition and may improve outcome in some patients with colorectal cancer. The aim of this study was to investigate whether dietary counseling, oral nutrition and megestrol acetate during chemotherapy affected nutritional status and survival in patients with advanced disease.
  
  
  METHODS
  Six hundred and twenty-eight patients with colorectal advanced disease were included in the study from January 2000 through December 2009 and divided into one of two groups. Group I consisted of 315 patients who were monitored prospectively and were given nutritional support. Group II included 313 patients without nutritional counseling and support. After the completion of chemotherapy all patients were evaluated (BMI, NST, Appetite Loss Scale and ECOG).
  
  
  RESULTS
  After the completion of chemotherapy, there were lower proportions of patients in Group I with a BMI<20, NST>=5, loss of appetite and decreased weight gain. Nutritional counseling and supplemental feeding temporarily halted weight loss and improved appetite. This improvement may have implications for patient survival. Patients with early nutritional support lived 19.1 months while patients in the control group had a survival of 12.4 months (p=0.022).
  
  
  CONCLUSIONS
  This study demonstrated that concurrent individualized dietary counseling and nutritional support are effective in improving nutritional status thereby lessening chemotherapy-induced morbidity.
authors.affiliation: Department of Radiotherapy and Oncology, Clinical Hospital Rijeka, Rijeka, Croatia. renatadobrila@windowslive.com
authors.forename: Renata
authors.initials: R
authors.lastname: Dobrila-Dintinjana
authors.forename: Dragan
authors.initials: D
authors.lastname: Trivanovic
authors.forename: Marko
authors.initials: M
authors.lastname: Zelić
authors.forename: Mladen
authors.initials: M
authors.lastname: Radić
authors.forename: Marijan
authors.initials: M
authors.lastname: Dintinjana
authors.forename: Duška
authors.initials: D
authors.lastname: Petranović
authors.forename: Valković
authors.initials: V
authors.lastname: Toni
authors.forename: Jelena
authors.initials: J
authors.lastname: Vukelic
authors.forename: Nusa
authors.initials: N
authors.lastname: Matijasic
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000188:drug therapy / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001069:Appetite Regulation; D019167:Appetite Stimulants / Q000627:therapeutic use; D015992:Body Mass Index; D002100:Cachexia / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D016009:Chi-Square Distribution; D015179:Colorectal Neoplasms / Q000150:complications / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D003376:Counseling; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D019290:Megestrol Acetate / Q000627:therapeutic use; D015596:Nutrition Assessment; D009752:Nutritional Status; D018529:Nutritional Support / Q000379:methods; D011446:Prospective Studies; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D000970:Antineoplastic Agents; D019167:Appetite Stimulants; D019290:Megestrol Acetate