• Assessment
    Are the measured energy needs of non-small cell lung cancer patients undergoing chemotherapy different from estimated needs?
    • Conclusion

      Two neutral quality time-series studies reported comparisons of average measured and estimated energy needs prior to chemotherapy and at the end of a course of chemotherapy in NSCLC patients.  Measured energy needs were expressed as a percentage of needs estimated by the HBE.   In one study, average measured and estimated energy needs were comparable (within 5% of each other) at both comparison times, with the exception of male subjects prior to chemotherapy (measured = 113% HBE).  In the second study that reported comparisons in a group of NSCLC patients (15/19 males), average measured REE was 112% HBE.  

    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    • Search Plan and Results: Calorie Needs vs. RDA: chemotherapy 2006
       
  • Intervention
    Is there a relationship between nutrition intervention to enhance intake (protein, kcals) to improve tolerance and support recovery from intensive chemotherapy for small cell lung cancer patients, and the reduction of complications associated with treatment?
    • Conclusion

      One two-group comparison study of neutral quality found that nutrition intervention by an RD to improve nutrition intake in patients receiving intensive chemotherapy for small cell lung cancer resulted in improved weight status (p < 0.01) and improved QOL (p < 0.001), but did not have a significant impact on either nutrition intake, nutritional status, or treatment outcome.  The average calorie and protein intake of the study period group (SPG) at initiation of the study was low at 20-25 kcal/kg/day, and 40% of SPG patients had a protein intake < 40 g/day.  Protein intake improved in the SPG group during the study period to an average 50 – 80 g/day per patient; no patient reached the desired level of 95-105 g/day.  Sixty four percent (64%) of patients used MFS at some point during treatment, and the researchers postulated that MFS use probably increased the average kcal and protein values. The study was limited by the use of historical controls.

    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    • Search Plan and Results: Protein and Symptoms/Complications: Chemotherapy 2006
       
    Is there a relationship between supplementation of multiple antioxidants and an interaction with paclitaxel and carboplatin chemotherapy protocols and tolerance of chemotherapy treatment in patients with non-small cell lung cancer?
    • Conclusion

      One positive quality RCT found supplementation with high-dose multiple antioxidants vitamin C (6100 mg/day), vitamin E (1050 mg/day) and synthetic beta carotene (60 mg/day) did not significantly influence response to treatment, survival, survival time and toxicity in patients receiving chemotherapy (paclitaxel and carboplatin) for advanced stage (IIIb and IV) non-small-cell lung cancer.

    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    • Search Plan and Results: Antioxidants and Chemotherapy 2006