Supportive Care in Cancer

, Volume 21, Issue 9, pp 2625–2636 | Cite as

A systematic review of health-related quality of life instruments in patients with cancer cachexia

  • Sally WheelwrightEmail author
  • Anne-Sophie Darlington
  • Jane B. Hopkinson
  • Deborah Fitzsimmons
  • Alice White
  • Colin D. Johnson
Review Article



Assessing the health-related quality of life (HRQOL) of cancer patients with cachexia is particularly important because treatments for cachexia are currently aimed at palliation and treatment efficacy must be measured in ways other than survival. The aim of this systematic review was to evaluate HRQOL assessment in cancer patients with cachexia.


Using guidance from the Centre for Reviews and Dissemination, relevant databases were searched from January 1980 to January 2012 with terms relating to cancer, cachexia and HRQOL for papers including adult cancer patients with cachexia or documented weight loss at baseline.


We found one cachexia-specific instrument, the Functional Assessment of Anorexia/Cachexia Therapy, but the tool has not been fully validated, does not cover all the relevant domains and the consensus-based standards for the selection of health status measurement instruments checklist highlighted a number of weaknesses in the methodological quality of the validation study. Sixty-seven studies assessed HRQOL in cachectic or weight-losing cancer patients. Most used generic cancer HRQOL instruments, limiting the amount of useful information they provide. A modified version of the Efficace minimum data checklist demonstrated that the quality of reporting on HRQOL tool use was inadequate in many of the studies. A negative relationship between HRQOL and weight loss was found in 23 of the 27 studies which directly examined this.


There is a pressing need for a well-designed HRQOL tool for use with this patient group in both clinical trials and clinical practice.


Cancer Health-related quality of life Systematic review Cachexia 



This work was made possible through funding from the European Organisation for Research and Treatment of Cancer Quality of Life (EORTC QOL) Group.

Conflict of interest

There is no conflict of interest to declare. No primary data were used for this paper, but the authors agree to allow the journal to review any secondary analysis carried out.


  1. 1.
    Fearon K, Strasser F, Anker SD, Bosaeus I, Bruera E, Fainsinger RL, Jatoi A, Loprinzi C, MacDonald N, Mantovani G, Davis M, Muscaritoli M, Ottery F, Radbruch L, Ravasco P, Walsh D, Wilcock A, Kaasa S, Baracos VE (2011) Definition and classification of cancer cachexia: an international consensus. Lancet Oncol 12(5):489–495. doi: 10.1016/s1470-2045(10)70218-7 Google Scholar
  2. 2.
    Bruera E (1997) ABC of palliative care. Anorexia, cachexia, and nutrition. BMJ 315(7117):1219–1222PubMedPubMedCentralGoogle Scholar
  3. 3.
    Tisdale MJ (2002) Cachexia in cancer patients. Nat Rev Cancer 2(11):862–871. doi: 10.1038/nrc927nrc927 Google Scholar
  4. 4.
    Churm D, Andrew IM, Holden K, Hildreth AJ, Hawkins C (2009) A questionnaire study of the approach to the anorexia–cachexia syndrome in patients with cancer by staff in a district general hospital. Support Care Cancer 17(5):503–507. doi: 10.1007/s00520-008-0486-1 PubMedGoogle Scholar
  5. 5.
    Ribaudo JM, Cella D, Hahn EA, Lloyd SR, Tchekmedyian NS, Von Roenn J, Leslie WT (2000) Re-validation and shortening of the Functional Assessment of Anorexia/Cachexia Therapy (FAACT) questionnaire. Qual Life Res 9(10):1137–1146Google Scholar
  6. 6.
    Aaronson NK (1990) Quality of life research in cancer clinical trials: a need for common rules and language. Oncology (Williston Park) 4(5):59–66, discussion 70Google Scholar
  7. 7.
    Souter J (2005) Loss of appetite: a poetic exploration of cancer patients' and their carers' experiences. Int J Palliat Nurs 11(10):524–532PubMedGoogle Scholar
  8. 8.
    Muir CI, Linklater GT (2011) A qualitative analysis of the nutritional requirements of palliative care patients. J Hum Nutr Diet 24(5):470–478. doi: 10.1111/j.1365-277X.2011.01182.x PubMedGoogle Scholar
  9. 9.
    McClement SE, Degner LF, Harlos MS (2003) Family beliefs regarding the nutritional care of a terminally ill relative: a qualitative study. J Palliat Med 6(5):737–748. doi: 10.1089/109662103322515248 PubMedGoogle Scholar
  10. 10.
    Reid J, McKenna H, Fitzsimons D, McCance T (2009) The experience of cancer cachexia: a qualitative study of advanced cancer patients and their family members. Int J Nurs Stud 46(5):606–616. doi: 10.1016/j.ijnurstu.2008.10.012 PubMedPubMedCentralGoogle Scholar
  11. 11.
    Hopkinson J, Corner J (2006) Helping patients with advanced cancer live with concerns about eating: a challenge for palliative care professionals. J Pain Symptom Manage 31(4):293–305. doi: 10.1016/j.jpainsymman.2005.09.005 PubMedGoogle Scholar
  12. 12.
    Strasser F, Binswanger J, Cerny T, Kesselring A (2007) Fighting a losing battle: eating-related distress of men with advanced cancer and their female partners. A mixed-methods study. Palliat Med 21(2):129–137. doi: 10.1177/0269216307076346 PubMedGoogle Scholar
  13. 13.
    Orrevall Y, Tishelman C, Herrington MK, Permert J (2004) The path from oral nutrition to home parenteral nutrition: a qualitative interview study of the experiences of advanced cancer patients and their families. Clin Nutr 23(6):1280–1287. doi: 10.1016/j.clnu.2004.04.006 PubMedGoogle Scholar
  14. 14.
    Hinsley R, Hughes R (2007) 'The reflections you get': an exploration of body image and cachexia. Int J Palliat Nurs 13(2):84–89PubMedGoogle Scholar
  15. 15.
    Holden CM (1991) Anorexia in the terminally ill cancer patient: the emotional impact on the patient and the family. Hosp J 7(3):73–84PubMedGoogle Scholar
  16. 16.
    Gwilliam B, Bailey C (2001) The nature of terminal malignant bowel obstruction and its impact on patients with advanced cancer. Int J Palliat Nurs 7(10):474–481PubMedGoogle Scholar
  17. 17.
    Locher JL, Robinson CO, Bailey FA, Carroll WR, Heimburger DC, Saif MW, Tajeu G, Ritchie CS (2010) Disruptions in the organization of meal preparation and consumption among older cancer patients and their family caregivers. Psychooncology 19(9):967–974. doi: 10.1002/pon.1656 PubMedPubMedCentralGoogle Scholar
  18. 18.
    Hopkinson J, Wright D, Corner J (2006) Exploring the experience of weight loss in people with advanced cancer. J Adv Nurs 54(3):304–312. doi: 10.1111/j.1365-2648.2006.03818 PubMedGoogle Scholar
  19. 19.
    Centre for Reviews and Dissemination (2009) Systematic reviews: CRD's guidance for undertaking reviews in health care [Internet]Google Scholar
  20. 20.
    Moher D, Liberati A, Tetzlaff J, Altman DG, The PG (2009) Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Med 6(7):e1000097. doi: 10.1371/journal.pmed.1000097 PubMedPubMedCentralGoogle Scholar
  21. 21.
    Argiles JM, Anker SD, Evans WJ, Morley JE, Fearon KCH, Strasser F, Muscaritoli M, Baracos VE (2010) Consensus on cachexia definitions. J Am Med Dir Assoc 11(4):229–230. doi: 10.1016/j.jamda.2010.02.004 PubMedGoogle Scholar
  22. 22.
    Terwee CB, Mokkink LB, Knol DL, Ostelo RW, Bouter LM, de Vet HC (2011) Rating the methodological quality in systematic reviews of studies on measurement properties: a scoring system for the COSMIN checklist. Qual Life Res. doi:10.1007/s11136-011-9960-1PubMedPubMedCentralGoogle Scholar
  23. 23.
    Efficace F, Bottomley A, Osoba D, Gotay C, Flechtner H, D'Haese S, Zurlo A (2003) Beyond the development of health-related quality-of-life (HRQOL) measures: a checklist for evaluating HRQOL outcomes in cancer clinical trials—does HRQOL evaluation in prostate cancer research inform clinical decision making? J Clin Oncol 21(18):3502–3511. doi: 10.1200/JCO.2003.12.121JCO.2003.12.121 PubMedGoogle Scholar
  24. 24.
    Cella DF, Bonomi AE, Leslie WT, VonRoenn J, Tchekmedyian NS (1993) Quality of life and nutritional well-being: measurement and relationship. Oncology 7(11):105–111Google Scholar
  25. 25.
    Hammerlid E, Wirblad B, Sandin C, Mercke C, Edstrom S, Kaasa S, Sullivan M, Westin T (1998) Malnutrition and food intake in relation to quality of life in head and neck cancer patients. Head Neck-J Sci Spec Head Neck 20(6):540–548Google Scholar
  26. 26.
    Ollenschlager G, Thomas W, Konkol K, Diehl V, Roth E (1992) Nutritional behaviour and quality of life during oncological polychemotherapy: results of a prospective study on the efficacy of oral nutrition therapy in patients with acute leukaemia. Eur J Clin Investig 22(8):546–553Google Scholar
  27. 27.
    Riechelmann RP, Burman D, Tannock IF, Rodin G, Zimmermann C (2010) Phase II Trial of Mirtazapine for Cancer-Related Cachexia and Anorexia. Am J Hosp Pallia Med 27(2):106–110. doi: 10.1177/1049909109345685 Google Scholar
  28. 28.
    Mantovani G, Maccio A, Madeddu C, Gramignano G, Lusso MR, Serpe R, Massa E, Astara G, Deiana L (2006) A phase II study with antioxidants, both in the diet and supplemented, pharmaconutritional support, progestagen, and anti-cyclooxygenase-2 showing efficacy and safety in patients with cancer-related anorexia/cachexia and oxidative stress. Cancer Epidemiol Biomark Prev 15(5):1030–1034. doi: 10.1158/1055-9965.epi-05-0538 Google Scholar
  29. 29.
    Poole K, Froggatt K (2002) Weight loss in advanced cancer: a literature review. LondonGoogle Scholar
  30. 30.
    Gavazzi C, Colatruglio S, Sironi A, Mazzaferro V, Miceli R (2011) Importance of early nutritional screening in patients with gastric cancer. Br J Nutr 106(12):1773–1778PubMedGoogle Scholar
  31. 31.
    Strasser F, Luftner D, Possinger K, Ernst G, Ruhstaller T, Meissner W, Ko YD, Schnelle M, Reif M, Cerny T (2006) Comparison of orally administered cannabis extract and delta-9-tetrahydrocannabinol in treating patients with cancer-related anorexia-cachexia syndrome: a multicenter, phase III, randomized, double-blind, placebo-controlled clinical trial from the Cannabis-In-Cachexia-Study-Group. J Clin Oncol 24(21):3394–3400. doi: 10.1200/jco.2005.05.1847 PubMedGoogle Scholar
  32. 32.
    Wiedenmann B, Malfertheiner P, Friess H, Ritch P, Arseneau J, Mantovani G, Caprioni F, Van Cutsem E, Richel D, DeWitte M, Qi M, Robinson D, Zhong B, De Boer C, Lu JD, Prabhakar U, Corringham R, Von Hoff D (2008) A multicenter, phase II study of infliximab plus gemcitabine in pancreatic cancer cachexia. J Support Oncol 6(1):18–25PubMedGoogle Scholar
  33. 33.
    Bowling A (2005) Mode of questionnaire administration can have serious effects on data quality. J Public Health (Oxf) 27(3):281–291. doi: 10.1093/pubmed/fdi031 Google Scholar
  34. 34.
    Cocks K, King MT, Velikova G, Fayers PM, Brown JM (2008) Quality, interpretation and presentation of European Organisation for Research and Treatment of Cancer quality of life questionnaire core 30 data in randomised controlled trials. Eur J Cancer 44(13):1793–1798. doi: 10.1016/j.ejca.2008.05.008 PubMedGoogle Scholar
  35. 35.
    Fitzsimmons D, Wheelwright S, Johnson CD (2012) Quality of life in pulmonary surgery: choosing, using, and developing assessment tools. Thorac Surg Clin 22(4):457–470. doi: 10.1016/j.thorsurg.2012.07.007 PubMedGoogle Scholar
  36. 36.
    Fayers P, Machin D (2007) Quality of life: the assessment, analysis and interpretation of patient-reported outcomes, 2nd edn. John Wiley & Sons, ChichesterGoogle Scholar
  37. 37.
    Guyatt G, Schunemann H (2007) How can quality of life researchers make their work more useful to health workers and their patients? Qual Life Res 16(7):1097–1105. doi: 10.1007/s11136-007-9223-3 PubMedGoogle Scholar
  38. 38.
    Evans WJ, Lambert CP (2007) Physiological basis of fatigue. Am J Phys Med Rehabil Assoc Acad Phys 86(1 Suppl):S29–46Google Scholar
  39. 39.
    Fearon KC, Voss AC, Hustead DS (2006) Definition of cancer cachexia: effect of weight loss, reduced food intake, and systemic inflammation on functional status and prognosis. Am J Clin Nutr 83(6):1345–1350PubMedGoogle Scholar
  40. 40.
    Ravasco P, Camilo M (2006) Patient-centered outcomes in cancer: nutrition makes a real difference. Curr Nutr Food Sci 2(2):193–203. doi: 10.2174/157340106776818871 Google Scholar
  41. 41.
    Persson CR, Johansson BBK, Sjoden PO, Glimelius BLG (2002) A randomized study of nutritional support in patients with colorectal and gastric cancer. Nutr Cancer Int J 42(1):48–58Google Scholar
  42. 42.
    Ravasco P, Monteiro-Grillo I, Marques Vidal P, Camilo ME (2004) Cancer: disease and nutrition are key determinants of patients' quality of life. Support Care Cancer 12(4):246–252. doi: 10.1007/s00520-003-0568- PubMedGoogle Scholar
  43. 43.
    Baracos VE, Reiman T, Mourtzakis M, Gioulbasanis I, Antoun S (2010) Body composition in patients with non-small cell lung cancer: a contemporary view of cancer cachexia with the use of computed tomography image analysis. Am J Clin Nutr 91(4):1133S–1137S. doi: 10.3945/ajcn.2010.28608C PubMedGoogle Scholar
  44. 44.
    Hopkinson JB (2010) The emotional aspects of cancer anorexia. Curr Opin Support Palliat Care 4(4):254–258. doi: 10.1097/SPC.0b013e32833ef813 PubMedGoogle Scholar
  45. 45.
    Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JC et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85(5):365–376Google Scholar
  46. 46.
    The EuroQol Group (1990) EuroQol—a new facility for the measurement of health-related quality of life. Health Policy 16(3):199–208Google Scholar
  47. 47.
    Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A, Silberman M, Yellen SB, Winicour P, Brannon J et al (1993) The Functional Assessment of Cancer Therapy scale: development and validation of the general measure. J Clin Oncol 11(3):570–579Google Scholar
  48. 48.
    Berk L, James J, Schwartz A, Hug E, Mahadevan A, Samuels M, Kachnic L (2008) A randomized, double-blind, placebo-controlled trial of a beta-hydroxyl beta-methyl butyrate, glutamine, and arginine mixture for the treatment of cancer cachexia (RTOG 0122). Support Care Cancer 16(10):1179–1188. doi: 10.1007/s00520-008-0403-7 PubMedGoogle Scholar
  49. 49.
    Bruera E, Ernst S, Hagen N, Spachynski K, Belzile M, Hanson J, Summers N, Brown B, Dulude H, Gallant G (1998) Effectiveness of megestrol acetate in patients with advanced cancer: a randomized, double-blind, crossover study. Cancer Prev Control 2(2):74–78PubMedGoogle Scholar
  50. 50.
    Fietkau R, Riepl M, Kettner H, Hinke A, Sauer R (1997) Supportive use of megestrol acetate in patients with head and neck cancer during radio(chemo)therapy. Eur J Cancer 33(1):75–79PubMedGoogle Scholar
  51. 51.
    Jatoi A, Windschitl HE, Loprinzi CL, Sloan JA, Dakhil SR, Mailliard JA, Pundaleeka S, Kardinal CG, Fitch TR, Krook JE, Novotny PJ, Christensen B (2002) Dronabinol versus megestrol acetate versus combination therapy for cancer-associated anorexia: a North Central Cancer Treatment Group Study. J Clin Oncol 20(2):567–573PubMedGoogle Scholar
  52. 52.
    Jatoi A, Rowland K, Loprinzi CL, Sloan JA, Dakhil SR, MacDonald N, Gagnon B, Novotny PJ, Mailliard JA, Bushey TI, Nair S, Christensen B (2004) An eicosapentaenoic acid supplement versus megestrol acetate versus both for patients with cancer-associated wasting: a North Central Cancer Treatment Group and National Cancer Institute of Canada collaborative effort. J Clin Oncol 22(12):2469–2476. doi: 10.1200/jco.2004.06.024 PubMedGoogle Scholar
  53. 53.
    Kornek GV, Schenk T, Ludwig H, Hejna M, Scheithauer W (1996) Placebo-controlled trial of medroxyprogesterone acetate in gastrointestinal malignancies and cachexia. Onkologie 19(2):164–168Google Scholar
  54. 54.
    Lindholm E, Daneryd P, Korner U, Hyltander A, Fouladiun M, Lundholm K (2004) Effects of recombinant erythropoietin in palliative treatment of unselected cancer patients. Clin Cancer Res 10(20):6855–6864PubMedGoogle Scholar
  55. 55.
    Lundholm K, Korner U, Gunnebo L, Sixt-Ammilon P, Fouladiun M, Daneryd P, Bosaeus I (2007) Insulin treatment in cancer cachexia: effects on survival, metabolism, and physical functioning. Clin Cancer Res 13(9):2699–2706. doi: 10.1158/1078-0432.ccr-06-2720 PubMedGoogle Scholar
  56. 56.
    Lundholm K, Gunnebo L, Korner U, Iresjo BM, Engstrom C, Hyltander A, Smedh U, Bosaeus I (2010) Effects by daily long term provision of ghrelin to unselected weight-losing cancer patients a randomized double-blind study. Cancer 116(8):2044–2052. doi: 10.1002/cncr.24917 PubMedGoogle Scholar
  57. 57.
    McMillan DC, Wigmore SJ, Fearon KC, O'Gorman P, Wright CE, McArdle CS (1999) A prospective randomized study of megestrol acetate and ibuprofen in gastrointestinal cancer patients with weight loss. Br J Cancer 79(3–4):495–500. doi: 10.1038/sj.bjc.6690077 PubMedPubMedCentralGoogle Scholar
  58. 58.
    Navari RM, Brenner MC (2010) Treatment of cancer-related anorexia with olanzapine and megestrol acetate: a randomized trial. Support Care Cancer 18(8):951–956. doi: 10.1007/s00520-009-0739-7 PubMedGoogle Scholar
  59. 59.
    Simons J, Aaronson NK, Vansteenkiste JF, tenVelde GPM, Muller MJ, Drenth BM, Erdkamp FLG, Cobben EGM, Schoon EJ, Smeets JBE, Schouten HC, Demedts M, Hillen HFP, Blijham GH, Wouters EFM (1996) Effects of medroxyprogesterone acetate on appetite, weight, and quality of life in advanced-stage non-hormone-sensitive cancer: a placebo-controlled multicenter study. J Clin Oncol 14(4):1077–1084PubMedGoogle Scholar
  60. 60.
    Tozer RG, Tai P, Falconer W, Ducruet T, Karabadjian A, Bounous G, Molson JH, Droge W (2008) Cysteine-rich protein reverses weight loss in lung cancer patients receiving chemotherapy or radiotherapy. Antioxid Redox Signal 10(2):395–402. doi: 10.1089/ars.2007.1919 PubMedGoogle Scholar
  61. 61.
    Trabal J, Leyes P, Forga M, Maurel J (2010) Potential usefulness of an EPA-enriched nutritional supplement on chemotherapy tolerability in cancer patients without overt malnutrition. Nutr Hosp 25(5):736–740. doi: 10.3305/nh.2010.25.5.4616 PubMedGoogle Scholar
  62. 62.
    Vadell C, Segui MA, Gimenez-Arnau JM, Morales S, Cirera L, Bestit I, Batiste E, Blanco R, Jolis L, Boleda M, Anton I (1998) Anticachectic efficacy of megestrol acetate at different doses and versus placebo in patients with neoplastic cachexia. Am J Clin Oncol Cancer Clin Trials 21(4):347–351Google Scholar
  63. 63.
    Westman G, Bergman B, Albertsson M, Kadar L, Gustavsson G, Thaning L, Andersson M, Straumits A, Jeppson B, Linden CJ, Ewers SB, Andersson H, Mercke C, Hafstrom L, Birck O, Orgum P (1999) Megestrol acetate in advanced, progressive, hormone-insensitive cancer. Effects on the quality of life: a placebo-controlled, randomised, multicentre trial. Eur J Cancer 35(4):586–595PubMedGoogle Scholar
  64. 64.
    Jatoi A, Ritter HL, Dueck A, Nguyen PL, Nikcevich DA, Luyun RF, Mattar BI, Loprinzi CL (2010) A placebo-controlled, double-blind trial of infliximab for cancer-associated weight loss in elderly and/or poor performance non-small cell lung cancer patients (N01C9). Lung Cancer 68(2):234–239PubMedGoogle Scholar
  65. 65.
    Persson C, Glimelius B (2002) The relevance of weight loss for survival and quality of life in patients with advanced gastrointestinal cancer treated with palliative chemotherapy. Anticancer Res 22(6B):3661–3668PubMedGoogle Scholar
  66. 66.
    Baldwin C, Spiro A, McGough C, Norman AR, Gillbanks A, Thomas K, Cunningham D, O'Brien M, Andreyev HJN (2011) Simple nutritional intervention in patients with advanced cancers of the gastrointestinal tract, non-small cell lung cancers or mesothelioma and weight loss receiving chemotherapy: a randomised controlled trial. J Hum Nutr Diet 24(5):431–440. doi: 10.1111/j.1365-277X.2011.01189.x PubMedGoogle Scholar
  67. 67.
    Breitkreutz R, Tesdal K, Jentschura D, Haas O, Leweling H, Holm E (2005) Effects of a high-fat diet on body composition in cancer patients receiving chemotherapy: a randomized controlled study. Wien Klin Wochenschr 117(19–20):685–692. doi: 10.1007/s00508-005-0455-3 PubMedGoogle Scholar
  68. 68.
    Davidson W, Ash S, Capra S, Bauer J (2004) Weight stabilisation is associated with improved survival duration and quality of life in unresectable pancreatic cancer. Clin Nutr 23(2):239–247. doi: 10.1016/j.clnu.2003.07.001 S026156140300133X PubMedGoogle Scholar
  69. 69.
    Fearon KC, Von Meyenfeldt MF, Moses AG, Van Geenen R, Roy A, Gouma DJ, Giacosa A, Van Gossum A, Bauer J, Barber MD, Aaronson NK, Voss AC, Tisdale MJ (2003) Effect of a protein and energy dense N-3 fatty acid enriched oral supplement on loss of weight and lean tissue in cancer cachexia: a randomised double blind trial. Gut 52(10):1479–1486PubMedPubMedCentralGoogle Scholar
  70. 70.
    Hasenberg T, Essenbreis M, Herold A, Post S, Shang E (2010) Early supplementation of parenteral nutrition is capable of improving quality of life, chemotherapy-related toxicity and body composition in patients with advanced colorectal carcinoma undergoing palliative treatment: Results from a prospective, randomized clinical trial. Color Dis 12(10):e190–e199. doi: 10.1111/j.1463-1318.2009.02111.x Google Scholar
  71. 71.
    May PE, Barber A, D'Olimpio JT, Hourihane A, Abumrad NN (2002) Reversal of cancer-related wasting using oral supplementation with a combination of beta-hydroxy-beta-methylbutyrate, arginine, and glutamine. Am J Surg 183(4):471–479PubMedGoogle Scholar
  72. 72.
    Ovesen L, Allingstrup L, Hannibal J, Mortensen EL, Hansen OP (1993) Effect of dietary counseling on food intake, body weight, response rate, survival, and quality of life in cancer patients undergoing chemotherapy: a prospective, randomized study. J Clin Oncol 11(10):2043–2049PubMedGoogle Scholar
  73. 73.
    Poon RT, Yu WC, Fan ST, Wong J (2004) Long-term oral branched chain amino acids in patients undergoing chemoembolization for hepatocellular carcinoma: a randomized trial. Aliment Pharmacol Ther 19(7):779–788. doi: 10.1111/j.1365-2036.2004.01920.x PubMedGoogle Scholar
  74. 74.
    Shang E, Weiss C, Post S, Kaehler G (2006) The influence of early supplementation of parenteral nutrition on quality of life and body composition in patients with advanced cancer. J Parenter Enter Nutr 30(3):222–230Google Scholar
  75. 75.
    Van VB-d, der Schuer MA, Langendoen SI, Vondeling H, Kuik DJ, Quak JJ, Van Leeuwen PA (2000) Perioperative enteral nutrition and quality of life of severely malnourished head and neck cancer patients: a randomized clinical trial. Clin Nutr 19(6):437–444. doi: 10.1054/clnu.2000.0148 Google Scholar
  76. 76.
    Taylor LA, Pletschen L, Arends J, Unger C, Massing U (2010) Marine phospholipids—a promising new dietary approach to tumor-associated weight loss. Support Care Cancer 18(2):159–170PubMedGoogle Scholar
  77. 77.
    Read JA, Beale PJ, Volker DH, Smith N, Childs A, Clarke SJ (2007) Nutrition intervention using an eicosapentaenoic acid (EPA)-containing supplement in patients with advanced colorectal cancer. Effects on nutritional and inflammatory status: a phase II trial. Support Care Cancer 15(3):301–307. doi: 10.1007/s00520-006-0153-3 PubMedGoogle Scholar
  78. 78.
    Burns CP, Halabi S, Clamon G, Kaplan E, Hohl RJ, Atkins JN, Schwartz MA, Wagner BA, Paskett E (2004) Phase II study of high-dose fish oil capsules for patients with cancer-related cachexia—a cancer and leukemia group B study. Cancer 101(2):370–378. doi: 10.1002/cncr.20362 PubMedGoogle Scholar
  79. 79.
    Mantovani G, Madeddu C, Maccio A, Gramignano G, Lusso MR, Massa E, Astara G, Serpe R (2004) Cancer-related anorexia/cachexia syndrome and oxidative stress: an innovative approach beyond current treatment. Cancer Epidemiol Biomark Prev 13(10):1651–1659Google Scholar
  80. 80.
    Neri B, Gemelli MT, Tarantini P, Benvenuti F, Khader A, Ludovici M, Michelotti R, Fabbroni S (1995) The role of megestrol-acetate in neoplastic anorexia and cachexia. CurrTher Res Clin Exp 56(2):183–189Google Scholar
  81. 81.
    Skarlos DV, Fountzilas G, Pavlidis N, Beer M, Makrantonakis P, Aravantinos G, Pantelakos P, Tsavaris N, Karpasitis N, Kosmidis P (1993) Megestrol-acetate in cancer-patients with anorexia and weight-loss—a hellenic cooperative oncology group (HECOG) study. Acta Oncol 32(1):37–41PubMedGoogle Scholar
  82. 82.
    Mantovani G, Maccio A, Madeddu C, Serpe R, Antoni G, Massa E, Dessi M, Panzone F (2010) Phase II nonrandomized study of the efficacy and safety of COX-2 inhibitor celecoxib on patients with cancer cachexia. J Mol Med-Jmm 88(1):85–92. doi: 10.1007/s00109-009-0547-z Google Scholar
  83. 83.
    Chasen M, Hirschman SZ, Bhargava R (2011) Phase II study of the novel peptide-nucleic acid OHR118 in the management of cancer-related anorexia/cachexia. J Am Med Dir Assoc 12(1):62–67. doi: 10.1016/j.jamda.2010.02.012 PubMedGoogle Scholar
  84. 84.
    Bozzetti F, Cozzaglio L, Biganzoli E, Chiavenna G, De Cicco M, Donati D, Gilli G, Percolla S, Pironi L (2002) Quality of life and length of survival in advanced cancer patients on home parenteral nutrition. Clin Nutr 21(4):281–288. doi: 10.1054/clnu.2002.0560 PubMedGoogle Scholar
  85. 85.
    Bauer JD, Capra S (2005) Nutrition intervention improves outcomes in patients with cancer cachexia receiving chemotherapy—a pilot study. Support Care Cancer 13(4):270–274. doi: 10.1007/s00520-004-0746-7 PubMedGoogle Scholar
  86. 86.
    Ferrucci LM, Bell D, Thornton J, Black G, McCorkle R, Heimburger DC, Saif MW (2011) Nutritional status of patients with locally advanced pancreatic cancer: a pilot study. Support Care Cancer 19(11):1729–1734. doi: 10.1007/s00520-010-1011-x PubMedGoogle Scholar
  87. 87.
    Fouladiun M, Korner U, Gunnebo L, Sixt-Ammilon P, Bosaeus I, Lundholm K (2007) Daily physical-rest activities in relation to nutritional state, metabolism, and quality of life in cancer patients with progressive cachexia. Clin Cancer Res 13:6379–6385. doi: 10.1158/1078-0432.ccr-07-1147 PubMedGoogle Scholar
  88. 88.
    van den Berg MG, Rasmussen-Conrad EL, van Nispen L, van Binsbergen JJ, Merkx MA (2008) A prospective study on malnutrition and quality of life in patients with head and neck cancer. Oral Oncol 44(9):830–837. doi: 10.1016/j.oraloncology.2007.11.002 PubMedGoogle Scholar
  89. 89.
    Dahele M, Skipworth RJ, Wall L, Voss A, Preston T, Fearon KC (2007) Objective physical activity and self-reported quality of life in patients receiving palliative chemotherapy. J Pain Symptom Manage 33(6):676–685. doi: 10.1016/j.jpainsymman.2006.09.024 PubMedGoogle Scholar
  90. 90.
    Andreyev HJ, Norman AR, Oates J, Cunningham D (1998) Why do patients with weight loss have a worse outcome when undergoing chemotherapy for gastrointestinal malignancies? Eur J Cancer 34(4):503–509PubMedGoogle Scholar
  91. 91.
    Norman K, Stobaus N, Smoliner C, Zocher D, Scheufele R, Valentini L, Lochs H, Pirlich M (2010) Determinants of hand grip strength, knee extension strength and functional status in cancer patients. Clin Nutr 29(5):586–591PubMedGoogle Scholar
  92. 92.
    Hutton JL, Baracos VE, Wismer WV (2007) Chemosensory dysfunction is a primary factor in the evolution of declining nutritional status and quality of life in patients with advanced cancer. J Pain Symptom Manag 33(2):156–165. doi: 10.1016/j.jpainsymman.2006.07.017 Google Scholar
  93. 93.
    Chang VT, Xia Q, Kasimis B (2005) The Functional Assessment of Anorexia/Cachexia Therapy (FAACT) Appetite Scale in veteran cancer patients. J Support Oncol 3(5):377–382PubMedGoogle Scholar
  94. 94.
    Richey LM, George JR, Couch ME, Kanapkey BK, Yin X, Cannon T, Stewart PW, Weissler MC, Shores CG (2007) Defining cancer cachexia in head and neck squamous cell carcinoma. Clin Cancer Res 13(22 Pt 1):6561–6567. doi: 10.1158/1078-0432.ccr-07-0116 PubMedGoogle Scholar
  95. 95.
    Xara S, Amaral TF, Parente B (2011) Undernutrition and quality of life in non-small cell lung cancer patients. Revista Portuguesa De Pneumologia 17(4):153–158. doi: 10.1016/j.rppneu.2011.01.006 PubMedGoogle Scholar
  96. 96.
    Capuano G, Gentile PC, Bianciardi F, Tosti M, Palladino A, Di Palma M (2010) Prevalence and influence of malnutrition on quality of life and performance status in patients with locally advanced head and neck cancer before treatment. Support Care Cancer 18(4):433–437. doi: 10.1007/s00520-009-0681-8 PubMedGoogle Scholar
  97. 97.
    Shahmoradi N, Kandiah M, Peng LS (2009) Impact of nutritional status on the quality of life of advanced cancer patients in hospice home care. Asian Pacific J Cancer Prev 10(6):1003–1009Google Scholar
  98. 98.
    Jones LW, Eves ND, Mackey JR, Peddle CJ, Haykowsky M, Joy AA, Tankel K, Courneya KS, Reiman T (2008) Systemic inflammation, cardiorespiratory fitness, and quality of life in patients with advanced non-small cell lung cancer. J Thorac Oncol 3(2):194–195PubMedGoogle Scholar
  99. 99.
    Nourissat A, Vasson MP, Merrouche Y, Bouteloup C, Goutte M, Mille D, Jacquin JP, Collard O, Michaud P, Chauvin F (2008) Relationship between nutritional status and quality of life in patients with cancer. Eur J Cancer 44(9):1238–1242. doi: 10.1016/j.ejca.2008.04.006 PubMedGoogle Scholar
  100. 100.
    Correia M, Cravo M, Marques-Vidal P, Grimble R, Dias-Pereira A, Faias S, Nobre-Leitao C (2007) Serum concentrations of TNF-alpha as a surrogate marker for malnutrition and worse quality of life in patients with gastric cancer. Clin Nutr 26(6):728–735. doi: 10.1016/j.clnu.2007.08.014 PubMedGoogle Scholar
  101. 101.
    O'Gorman P, McMillan DC, McArdle CS (1998) Impact of weight loss, appetite, and the inflammatory response on quality of life in gastrointestinal cancer patients. Nutr Cancer Int J 32(2):76–80Google Scholar
  102. 102.
    Ovesen L, Hannibal J, Mortensen EL (1993) The interrelationship of weight-loss, dietary-intake, and quality-of-life in ambulatory patients with cancer of the lung, breast, and ovary. Nutr Cancer Int J 19(2):159–167Google Scholar
  103. 103.
    Scott HR, McMillan DC, Brown DJ, Forrest LM, McArdle CS, Milroy R (2003) A prospective study of the impact of weight loss and the systemic inflammatory response on quality of life in patients with inoperable non-small cell lung cancer. Lung Cancer 40(3):295–299PubMedGoogle Scholar
  104. 104.
    Capuano G, Pavese I, Satta F, Tosti M, Palladino A, Del Grosso A, Di Palma M (2008) Correlation between anemia, unintentional weight loss and inflammatory status on cancer-related fatigue and quality of life before chemo and radiotherapy. e-SPEN 3(4):e147–e151. doi: 10.1016/j.eclnm.2008.04.008 Google Scholar
  105. 105.
    Petruson KM, Silander EM, Hammerlid EB (2005) Quality of life as predictor of weight loss in patients with head and neck cancer. Head Neck-J Sci Specialt Head Neck 27(4):302–310. doi: 10.1002/hed.20172 Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Sally Wheelwright
    • 1
    • 5
    Email author
  • Anne-Sophie Darlington
    • 2
  • Jane B. Hopkinson
    • 3
  • Deborah Fitzsimmons
    • 4
  • Alice White
    • 1
  • Colin D. Johnson
    • 1
  1. 1.Cancer SciencesUniversity of SouthamptonSouthamptonUK
  2. 2.Health SciencesUniversity of SouthamptonSouthamptonUK
  3. 3.Cardiff School of Nursing and Midwifery Studies, School of Biomedical and Life SciencesCardiff UniversityCardiffUK
  4. 4.Swansea Centre for Health EconomicsSwansea UniversitySwanseaUK
  5. 5.University Surgical Unit (MP 816)Southampton General HospitalSouthamptonUK

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