Alexandra Uster1, Maya Ruehlin1, Stefanie Mey2, David Gisi2, Ruud Knols3, Reinhard Imoberdorf1, Miklos Pless1, Peter E Ballmer4. 1. Kantonsspital Winterthur, Department of Medicine, CH-8401 Winterthur, Switzerland. 2. Kantonsspital Winterthur, Institute of Physical Therapy, CH-8401 Winterthur, Switzerland. 3. Universitätsspital Zürich, Directory of Research and Education, Physiotherapy Occupational Therapy Research Center, CH-8091 Zürich, Switzerland. 4. Kantonsspital Winterthur, Department of Medicine, CH-8401 Winterthur, Switzerland. Electronic address: peter.ballmer@ksw.ch.
Abstract
BACKGROUND & AIMS: Cancer cachexia is multifactorial and should be targeted using a multimodal form of intervention. The purpose of the present trial was to test the effects of a combined nutrition and physical exercise program on cancer patients with metastatic or locally advanced tumors of the gastrointestinal and lung tracts. METHODS: Patients were randomized into two groups: One group received a minimum of three standardized individual nutritional counselling sessions and participated in a 60-min exercise program twice a week. The second group received their usual care. The intervention spanned a period of three months. Quality of life (European Organization for Research and Treatment of Cancer Quality of LifeQuestionnaire version 3.0), physical performance (hand-grip strength, 6-min walk test, timed sit-to-stand test and 1 repetition maximum leg press), nutritional status (body weight, bioelectrical impedance analysis), dietary intake (three-day dietary record) and clinical data (unexpected hospital days, performance status) were tested at baseline and after three and six months. RESULTS: In total, 18 women and 40 men (mean age 63, range 32-81) with metastatic or locally advanced tumors of the gastrointestinal (n = 38) and lung (n = 20) tracts were included. Median adherence to the supervised exercise program was 75%. The median number of individual nutritional counselling sessions was 3.0 (range 0-7 sessions). Post intervention, no difference in global health status/quality of life (overall QoL) was observed. Intervention was superior to UC for the patient-rated symptom scale regarding nausea and vomiting (p = 0.023) and protein intake (p = 0.01). No statistical differences were observed for energy intake, nutritional status and physical performance. CONCLUSIONS: The results show good adherence to a combined nutrition and exercise program. The multimodal intervention did not improve overall QoL, but contributed to an adequate protein intake and to the general well-being of the patient by reducing nausea and vomiting.
RCT Entities:
BACKGROUND & AIMS:Cancer cachexia is multifactorial and should be targeted using a multimodal form of intervention. The purpose of the present trial was to test the effects of a combined nutrition and physical exercise program on cancerpatients with metastatic or locally advanced tumors of the gastrointestinal and lung tracts. METHODS:Patients were randomized into two groups: One group received a minimum of three standardized individual nutritional counselling sessions and participated in a 60-min exercise program twice a week. The second group received their usual care. The intervention spanned a period of three months. Quality of life (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire version 3.0), physical performance (hand-grip strength, 6-min walk test, timed sit-to-stand test and 1 repetition maximum leg press), nutritional status (body weight, bioelectrical impedance analysis), dietary intake (three-day dietary record) and clinical data (unexpected hospital days, performance status) were tested at baseline and after three and six months. RESULTS: In total, 18 women and 40 men (mean age 63, range 32-81) with metastatic or locally advanced tumors of the gastrointestinal (n = 38) and lung (n = 20) tracts were included. Median adherence to the supervised exercise program was 75%. The median number of individual nutritional counselling sessions was 3.0 (range 0-7 sessions). Post intervention, no difference in global health status/quality of life (overall QoL) was observed. Intervention was superior to UC for the patient-rated symptom scale regarding nausea and vomiting (p = 0.023) and protein intake (p = 0.01). No statistical differences were observed for energy intake, nutritional status and physical performance. CONCLUSIONS: The results show good adherence to a combined nutrition and exercise program. The multimodal intervention did not improve overall QoL, but contributed to an adequate protein intake and to the general well-being of the patient by reducing nausea and vomiting.
Authors: M Durán-Poveda; P Jimenez-Fonseca; M Sirvent-Ochando; P P García-Luna; J L Pereira-Cunill; B Lema-Marqués; M T Parejo-Arrondo; C Belda-Iniesta Journal: Clin Transl Oncol Date: 2018-03-02 Impact factor: 3.405
Authors: Alexander Haussmann; Nadine Ungar; Angeliki Tsiouris; Monika Sieverding; Joachim Wiskemann; Karen Steindorf Journal: Int J Behav Med Date: 2020-02