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Individualized nutrition intervention is of major benefit to colorectal cancer patients: long-term follow-up of a randomized controlled trial of nutritional therapy.
- Source :
- American Journal of Clinical Nutrition; Dec2012, Vol. 96 Issue 6, p1346-1353, 8p, 3 Charts, 3 Graphs
- Publication Year :
- 2012
-
Abstract
- Background: In our published randomized trial in colorectal cancer, group 1 (n = 37) received individualized nutritional counseling and education about regular foods, group 2 (n = 37) received dietary supplements and consumed their usual diet of regular foods, and group 3 (n = 37) consumed their usual diet of regular foods. Neither group 2 nor group 3 received individualized counseling. Early nutritional counseling during radiotherapy was highly effective at reducing acute radiotherapy toxicity and improving nutritional intake/status and quality of life (QoL). Efficacy persisted for 3 mo after the intervention. Objective: The objective was to perform long-term follow-up in survivors of that clinical trial to specifically evaluate survival, late toxicity, QoL, and nutritional variables. Design: Medical data were collected from patients' records, and pre- scheduled interviews were conducted by dietitians for individualized evaluations. Analyses and comparisons between groups (adjusted for stage) were performed after a median follow-up of 6.5 (range: 4.9-8.1) y. Results: Patients complied with the Radiotherapy Department's follow-up protocol. Nutritional deterioration was higher (P < 0.001) in group 3 (n = 26) and group 2 (n = 29) than in group 1 (n = 34). Adequate nutritional status was maintained in 91% of group 1 patients but not in any of the group 3 patients (P < 0.002). Intakes in group ! were similar to reference values, and the patients adhered to the prescribed recommendations. Intakes in groups 2 and 3 were lower than recommended intakes: group 3 = group 2 < group 1 (P = 0.001). Median survival in group 3 was 4.9 y (30% died), in group 2 was 6.5 y (22% died), and in group 1 was 7.3 y (only 8% died): group 3 > group 2 > group 1 (P < 0.01). Late radiotherapy toxicity was higher in group 3 (n = 17; 65%) and group 2 (n = 17; 59%) than in group 1 (n = 3; 9%): group 3 = group 2 > group 1 (P < 0.001). QoL was worse in groups 3 and 2 than in group 1 : group 3 - group 2 < group 1 (P < 0.002). Worse radiotherapy toxicity, QoL, and mortality were associated with deteriorated nutritional status and intake (P < 0.001). Likewise, depleted intake, nutritional status, and QoL predicted shorter survival and late toxicity (HR: 8.25; 95% CI: 2.74, 1.47; P < 0.001). Conclusions: This study conveys novel information about the effectiveness of nutrition at improving long-term prognosis in colorectal cancer. Overall, the data indicate that early individualized nutritional counseling and education during radiotherapy is valuable for patients. [ABSTRACT FROM AUTHOR]
- Subjects :
- RECTUM tumors
COLON tumors
ANALYSIS of variance
CHI-squared test
DIET therapy
INGESTION
LONGITUDINAL method
EVALUATION of medical care
MORTALITY
MULTIVARIATE analysis
NUTRITION counseling
QUALITY of life
QUESTIONNAIRES
RADIOTHERAPY
RESEARCH funding
STATISTICAL hypothesis testing
STATISTICS
SURVIVAL analysis (Biometry)
DATA analysis
DATA analysis software
DESCRIPTIVE statistics
KAPLAN-Meier estimator
NUTRITIONAL status
TUMOR treatment
Subjects
Details
- Language :
- English
- ISSN :
- 00029165
- Volume :
- 96
- Issue :
- 6
- Database :
- Complementary Index
- Journal :
- American Journal of Clinical Nutrition
- Publication Type :
- Academic Journal
- Accession number :
- 83624642
- Full Text :
- https://doi.org/10.3945/ajcn.111.018838