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Recommendations Summary

ONC: Small-cell lung Cancer: Chemotherapy and Medical Nutrition Therapy 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.


  • Recommendation(s)

    ONC: Lung cancer: MNT and Chemotherapy

    Medical Nutrition Therapy (MNT) that consists of nutrition assessment, intensive intervention, and ongoing monitoring and evaluation by an RD may be of benefit to patients with small cell lung cancer undergoing chemotherapy. Providing MNT may improve protein and calorie intake, which has been shown to improve weight status and QOL.

    Rating: Weak
    Imperative

    • Risks/Harms of Implementing This Recommendation

      No potential risks and harms are associated with the application of this recommendation.

    • Conditions of Application

      No conditions limit the application of this recommendation.

    • Potential Costs Associated with Application

      Costs of MNT sessions and reimbursement vary.

    • Recommendation Narrative

      • In a two-group comparison study of neutral quality (Glimelius et al, 1992) nutrition intervention by an RD to improve nutrition intake in patients receiving intensive chemotherapy for small cell lung cancer resulted in improved weight status and QOL, but did not have a significant impact on nutrition intake, nutritional status, or treatment outcome.
        • At the start of the study, the average calorie and protein intake of the study period group (SPG) at initiation of the study was low (20-25 kcal/kg/day) and 40% of SPG patients had a protein intake < 40 g/day.
        • During the study period, protein intake improved in the SPG group (average 50-80 g/day per patient), but no patient reached the desired protein intake level pf 95-105 g/day. 
        • Sixty four percent (64%) used oral supplements at some point during treatment, which probably increased calorie and protein values.
        • The study was limited by the use of historical controls. 
      • More research is needed to evaluate the impact of RD interventions on treatment related outcomes and survival.

    • Recommendation Strength Rationale

      • Based on one two-group comparison study of neutral quality, conclusion statement is Grade III.