ONC: Colorectal Cancer: Radiation 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.
ONC: Colorectal cancer: Radiation and MNT
Dietitians should provide weekly Medical Nutrition Therapy (MNT) that includes an individualized nutrition prescription and counseling for patients with colorectal cancer undergoing pelvic radiation. Individualized counseling with a focus on the consumption of regular foods may improve calorie and protein intake, nutrition status, quality of life (QOL) and reduce symptoms of anorexia, nausea, vomiting and diarrhea.
Risks/Harms of Implementing This Recommendation
No potential risks or 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.
- In a positive quality RCT (Ravasco et al, 2005), patients with colorectal cancer undergoing radiation therapy were given individualized dietary counseling plus a regular diet, resulting in a significantly less decline in nutritional status (PG-SGA; p< 0.02), fewer toxicity symptoms (Grade 1 and 2 combined anorexia, grade 1 and 2 combined nausea/vomiting, grade 1 and 2 combined diarrhea; p-values < 0.01), and improved QOL (EORTC QLQ); improvement in 6 function scores), when compared to groups receiving oral supplementation or no nutrition intervention. The researchers concluded that individualized counseling with a focus on the consumption of regular foods may improve caloric and protein intake, nutrition status, quality of life and reduce symptoms of anorexia, nausea, vomiting and diarrhea.
- Further research into the role of nutrition intervention in radiation therapy for colorectal cancer is needed.
Recommendation Strength Rationale
- Based on one positive quality RCT, conclusion statement is a Grade III.
- Risks/Harms of Implementing This Recommendation
The recommendations were created from the evidence analysis on the following questions. To see detail of the evidence analysis, click the blue hyperlinks below (recommendations rated consensus will not have supporting evidence linked).
Is there a relationship between nutrition intervention to improve nutritional intake (protein and kcals) to reduce symptoms and the reduction of symptoms associated with pelvic radiation therapy for colorectal cancer patients?