Abstract
Purpose
To establish a multidisciplinary Cancer Nutrition Rehabilitation Program (CNRP) for the management of the anorexia–cachexia syndrome (ACS) in an Australian cancer center and to evaluate outcomes of 2 months participation in the CNRP
Method
Patients were eligible if they had significant anorexia/weight loss, identified by their oncologist or the Malnutrition Screening Tool. In the 9 months that funding was available, 54 participants (37 males, 17 females; median age, 62 years) enrolled. They had mainly lung or gastrointestinal cancers, with 67% receiving chemotherapy concomitantly. Baseline assessments of nutrition and physical status were: median weight 62.7 kg, median weight loss 10.2%, median BMI 21.2 kg/m2, and 78% malnourished according to PG-SGA. Median baseline Karnofsky performance score (KPS) was 70%, with reduced right-hand grip strength (RGHS; median, 27 kg) and endurance (median, 6 min walk test 6MWT 442 m). Patients received individualized nutritional interventions, exercise programs, and symptom management and were followed prospectively for up to 6 months.
Results
Twenty-five (58%) of 41 evaluable CNRP participants attended the 2-month follow-up. Median weight (63.4 kg), KPS (80%), endurance (6MWT 570 m), and strength (RGHS 28 kg) were all improved. Edmonton symptom assessment scores (36 vs 27) and C-reactive protein levels (39 vs 22) fell. Participants were significantly more likely to return for re-evaluation if at baseline they were having anticancer therapy (odds ratio [OR] 4.7, 95% confidence interval [CI] 1.3–16.2) or could walk >420 m in 6 min (OR 21, 95% CI 1.9–227).
Conclusion
A CNRP may be beneficial for patients with advanced cancer and the ACS, but identification of patients who are likely to stay on the program is needed.
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Acknowledgment
The authors acknowledged the financial support of the New South Wales Cancer Institute’s Health Services Innovation Grant program in funding this project.
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Glare, P., Jongs, W. & Zafiropoulos, B. Establishing a cancer nutrition rehabilitation program (CNRP) for ambulatory patients attending an Australian cancer center. Support Care Cancer 19, 445–454 (2011). https://doi.org/10.1007/s00520-010-0834-9
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DOI: https://doi.org/10.1007/s00520-010-0834-9