title: Potential benefits of early nutritional intervention in adults with upper gastrointestinal cancer: a pilot randomised trial.
abstract: OBJECTIVE
  This study aimed to test whether a very early nutrition intervention delivered over the telephone was feasible and could improve outcomes amongst patients with upper gastrointestinal cancer.
  
  
  METHODS
  Participants with a histologically proven new diagnosis of primary oesophageal or stomach cancer and who were to undergo surgery and/or chemotherapy were randomised to receive either standard nutrition care (SC) or early and intensive nutrition intervention (NI) over the telephone/face-to-face. Participants were followed for 6 months. The primary outcome was quality of life (QoL), assessed using the European Organization for Research and Treatment of Cancer Global Quality of Life questionnaire C30 (EORTC QLQ-C30) and the European Quality of Life Instrument (EQ-5D) tool; secondary outcomes were nutritional status and survival.
  
  
  RESULTS
  Twenty-one participants were recruited (11 SC and 10 NI). At baseline, the prevalence of malnutrition was 90 %. Compared with SC, the NI group had a significantly higher EORTC global QoL score at the first mid-study follow-up (coefficient (95 % CI) 21.0 (12.1, 29.9) adjusted for baseline, p < 0.001) and at 26 weeks (28.4 (21.3, 35.4) adjusted for baseline, p < 0.001). Nutritional risk score was lower (p < 0.001), and loss of body weight attenuated (p < 0.001) in the NI group compared with SC. Six deaths occurred during the study, five in the SC group and one in the NI group (p = 0.06). The mean time spent with a dietitian per contact was significantly less for the NI group compared with SC (16(3) vs 40(6) min per dietetic contact, p < 0.001).
  
  
  CONCLUSIONS
  This pilot study has shown the potential of a novel telephone-based early and intensive dietetic model of care for newly diagnosed upper gastrointestinal cancer patients.
authors.affiliation: Department of Dietetics, Monash Health, Monash Medical Centre, 246 Clayton Rd, Clayton, Victoria, 3168, Australia, MaryAnne.Silvers@monashhealth.org.
authors.forename: Mary Anne
authors.initials: MA
authors.lastname: Silvers
authors.forename: June
authors.initials: J
authors.lastname: Savva
authors.forename: Catherine E
authors.initials: CE
authors.lastname: Huggins
authors.forename: Helen
authors.initials: H
authors.lastname: Truby
authors.forename: Terry
authors.initials: T
authors.lastname: Haines
mesh_terms: D000368:Aged; D004938:Esophageal Neoplasms / Q000628:therapy*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D044623:Nutrition Therapy / Q000379:methods*; D009752:Nutritional Status; D010166:Palliative Care / Q000379:methods*; D010865:Pilot Projects; D011788:Quality of Life; D013274:Stomach Neoplasms / Q000628:therapy*