Outcomes from a pilot randomised controlled trial of early and intensive dietary counselling in lung cancer patients receiving (chemo)radiotherapy. — ASN Events
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Outcomes from a pilot randomised controlled trial of early and intensive dietary counselling in lung cancer patients receiving (chemo)radiotherapy. (#210)

Nicole Kiss 1 2 3 , Elisabeth Isenring 4 5 , Karla Gough 1 , Greg Wheeler 6 , Andrew Wirth 6 , Belinda Campbell 6 , Mei Krishnasamy 1 2
  1. Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
  2. School of Health Sciences, Univesity of Melbourne, Parkville, Victoria, Australia
  3. Nutrition and Speech Pathology Department, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
  4. Faculty of Health Sciences and Medicine, Bond University, Robina, Queensland, Australia
  5. Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Queensland, Australia
  6. Lung Service, Peter MacCallum Cancer Centre, Malbourne, Victoria, Australia

Aims: Intensive dietary counselling has not been evaluated in lung cancer patients receiving (chemo)radiation despite a high prevalence of malnutrition. This study aimed to evaluate the feasibility and impact of intensive dietary counselling on nutritional, functional and fatigue outcomes.
Methods: This phase II nutrition intervention study included 24 lung cancer patients randomised to the intervention or usual care. The intervention employed a care pathway to guide intensive, individualised nutritional management up to 6 weeks following radiotherapy. Feasibility was assessed through recruitment, attrition and questionnaire completion rates. Nutritional (patient-generated subjective global assessment, weight, fat-free mass) and QOL (FACT-L functional and physical wellbeing) outcomes were assessed before randomisation, start and end of radiotherapy, at one and 3 months post-radiotherapy. Outcomes were analysed with linear mixed models.
Results: Twenty-four participants were recruited (50% male, mean age 63.4 + 12.2 years). Recruitment, attrition and questionnaire completion rates were 57%, 37% and 100%, respectively. Relative to baseline, intervention patients (n=12) showed clinically important benefits at the end of radiotherapy compared to usual care patients (n=12): weight (3.0kg; 95%CI -0.8, 6.8, effect size= .7, p=.11) and fat-free mass (0.6kg; 95%CI -2.1, 3.3, effect size= .19, p=.66) improved, and physical (2.1; 95%CI -2.3, 6.5, effect size= .42, p=.33) and functional wellbeing (5.1; 95%CI 1.6, 8.6, effect size= 1.29, p=0.01) deteriorated less. Three months post-radiotherapy, intervention benefits for weight (5.5kg; 95%CI -1.4, 12.3, effect size= .71, p=.71) and fat-free mass (1.48kg; 95%CI -0.5, 3.5, effect size= .67, p=.14) were sustained. At this time, physical and functional wellbeing had improved relative to baseline in both groups and between-groups differences were small.
Conclusions: In this pilot, study dietary counselling improved weight, fat-free mass, fatigue and functional outcomes in lung cancer patients receiving (chemo)radiotherapy. Results suggest the intervention is feasible and should be further evaluated in a phase III randomised trial.

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