Two time-series studies (neutral quality) expressed the measured REE of breast cancer patients as a percentage of estimated REE as predicted by the HBE equation.

One of the studies found that the measured REE of patients with advanced metastatic breast cancer was comparable to REE as predicted by HBE (98.6 ± 9.6% HBE). Average measured and estimated energy needs of patients with advanced metastatic breast cancer were comparable to those of healthy controls (within 5% of each other).

In the second study that reported a comparison between measured and estimated energy expenditure, the researchers found that patients with early-stage breast cancer receiving adjuvant chemotherapy had a measured REE that was comparable to REE as estimated by HBE (100.5 ± 8.0% HBE).  However, the breast cancer patients' REE was significantly higher than that of healthy control subjects (100.5 ± 8.0% HBE vs. 94.5 + 8.5% HBE respectively; P < 0.05).

Further study is needed to determine the effects of breast cancer and breast cancer treatment on patients' actual energy expenditure. 

• 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.

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 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.

• 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.

One (1) longitudinal time-series study (neutral quality rating) expressed the measured resting energy expenditure [REE] of metastatic melanoma patients as a percentage of estimated REE as predicted by the Harris-Benedict [HB]equation.  Average measured and estimated energy needs of patients were comparable (within 5% of each other).   The study found no significant differences in REE between the study group and healthy control subjects (101.4 + 11% Harris-Benedict vs. 101.4 + 9% Harris-Benedict respectively). 

• 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.

One small positive quality RCT examined the energy needs of testicular patients undergoing chemotherapy while receiving TPN plus spontaneous intake or oral diet alone.  The mean predicted REE using HBE was similar to measured REE only in the pre-treatment TPN group.  The mean predicted and measured REE were not similar in the control group pre- and post-treatment or in the post-treatment TPN group.  More research is needed to identify the most accurate predictive equation for this population.    

• 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.