Nutritional Care in Cancer Chemotherapy

Abstract

Aim: To evaluate the impact of structured nutritional care on the nutritional status, treatment tolerance, and clinical outcomes of cancer patients undergoing chemotherapy.

Materials and methods: This was a prospective, randomized controlled trial conducted at a tertiary oncology centre. Adults (≥18 years) with solid tumors starting cytotoxic chemotherapy, ECOG 0–2, and treatment duration ≥8 weeks were eligible. Patients with concurrent tube/parenteral nutrition, uncontrolled endocrine disease, refractory nausea/vomiting, pregnancy/lactation, or inability to consent were excluded. One hundred participants were randomized 1:1 to Intensive Nutritional Care (INC) or Usual Care (UC) using computer-generated blocks, stratified by tumor site (GI vs non-GI) and baseline nutritional risk (PG-SGA A vs B/C). Ethical approval and written informed consent were obtained.

Results: In this study of 100 cancer patients undergoing chemotherapy (INC = 50, UC = 50), baseline characteristics were comparable between groups, with 60% classified as malnourished by PG-SGA. At the end of treatment, the intervention group (INC) showed better outcomes, including lower PG-SGA scores (5.8 vs. 9.2), stable body weight compared to loss in UC, higher serum albumin levels (3.74 vs. 3.48 g/dL), and greater achievement of energy targets (88% vs. 54%). Additionally, chemotherapy dose reductions were less frequent in INC (14%) than UC (32%), indicating that structured nutritional care improved nutritional status, energy intake, and treatment tolerance.

Conclusion: Early and structured nutritional care during chemotherapy improves nutritional status, treatment tolerance, and overall outcomes in cancer patients.