Recommendations Summary
ONC: Esophageal Cancer: Chemoradiation and Medical Nutrition Therapy (MNT) 2007
Click here to see the explanation of recommendation ratings (Strong, Fair, Weak, Consensus, Insufficient Evidence) and labels (Imperative or Conditional). To see more detail on the evidence from which the following recommendations were drawn, use the hyperlinks in the Supporting Evidence Section below.
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Recommendation(s)
ONC: Esophageal cancer: Chemoradiation and MNT
The Dietitian should provide Medical Nutrition Therapy (MNT) consisting of a pre-treatment evaluation and weekly visits for six weeks during chemoradiation treatment for esophageal cancer to improve outcomes. MNT may reduce the amount of weight loss, unplanned hospitalizations, LOS, as well as improves tolerance to treatment and the likelihood of receiving prescribed radiation dose.
Rating: Weak
Imperative
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Risks/Harms of Implementing This Recommendation
No potential risks and harms are associated with the application of this recommendation.
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Conditions of Application
No conditions limit the application of this recommendation.
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Potential Costs Associated with Application
Costs of MNT sessions and reimbursement vary.
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Recommendation Narrative
- One neutral quality retrospective chart review study (Odelli et al, 2005) found that implementation of a standard nutrition pathway by an RD is associated with improved outcomes in esophageal cancer patients, including decreased weight loss, fewer unplanned hospital admissions during treatment, shorter LOS during unplanned hospital admissions, and improved tolerance of treatment as assessed by completion of the prescribed treatment course and percent desired radiation received.
- The researchers recommended that all esophageal cancer patients planning chemoradiation treatment receive a proactive nutrition assessment by a trained oncology RD on initial presentation, and that all patients receive appropriate nutrition support by a multidisciplinary team.
- Further research is needed to determine the frequency, duration and optimal length of nutrition intervention for improved treatment-related outcomes and survival.
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Recommendation Strength Rationale
- Based on one neutral quality retrospective chart review study, conclusion statement is Grade III.
