Elisabeth Isenring PhD AdvAPD, Clinical Academic Fellow
Updated evidence-based practice guidelines for the nutritional management of patients receiving radiation therapy and/or chemotherapy
Article first published online: 29 JAN 2013
© 2013 The Authors. Nutrition & Dietetics © 2013 Dietitians Association of Australia
Nutrition & Dietetics
Volume 70, Issue 4, pages 312–324, December 2013
How to Cite
Isenring, E., Zabel, R., Bannister, M., Brown, T., Findlay, M., Kiss, N., Loeliger, J., Johnstone, C., Camilleri, B., Davidson, W., Hill, J. and Bauer, J. (2013), Updated evidence-based practice guidelines for the nutritional management of patients receiving radiation therapy and/or chemotherapy. Nutrition & Dietetics, 70: 312–324. doi: 10.1111/1747-0080.12013
Rachel Zabel PhD APD, Accredited Practising Dietitian
Melanie Bannister BHSc (Nut& Diet)(Hons)APD, Accredited Practising Dietitian
Teresa Brown PGDNutDiet APD, Dietitian Team Leader
Merran Findlay MSc Nutr& Diet APD, Cancer Services Development Manager
Nicole Kiss MND AdvAPD, Senior Clinician – Dietitian
Jenelle Loeliger MND AdvAPD, Head of Nutrition Department
Cara Johnstone MNutrDiet APD, Senior Cancer Care Dietitian
Belinda Camilleri BHSc (Nut& Diet)(Hons) APD, Senior Oncology Dietitian
Wendy Davidson M App Sc (Res)AdvAPD, Team Leader
Jan Hill MPH, AdvAPD, Program Manager
Judy Bauer PhD MHSc AdvAPD, Associate Professor in Dietetics and Manger of Nutrition and Dietetics
- Issue published online: 12 DEC 2013
- Article first published online: 29 JAN 2013
- Manuscript Accepted: NOV 2012
- evidence-based guidelines;
- radiation therapy;
The aim of this paper was to update the evidence-based practice guidelines for the nutritional management of patients receiving radiation therapy and broaden the scope to include chemotherapy.
The following databases were searched using a range of keywords: Cochrane Database, CENTRAL, MEDLINE (via Ebscohost), EMBASE, CINAHL (Ebscohost), Web of Science, Health Source: Nursing/Academic Edition and PubMed. Relevant papers (n = 47) were reviewed by at least two members of the steering committee and assigned a level of evidence and a quality rating.
There were no new published randomised controlled trials (RCTs) of nutrition intervention in radiation therapy. Most statements in the previous radiation therapy guidelines have strong evidence supporting nutrition intervention. There were 12 studies in chemotherapy including five RCTs. While these studies provided strong evidence that simple nutrition intervention improves nutritional outcomes such as dietary intake and weight, they did not find an improvement in quality of life or survival. Several RCTs found no benefits of nutrition support in patients undergoing chemotherapy. None of the RCTs in chemotherapy used medical nutrition therapy (MNT) as the intervention, but rather simple dietary advice and/or supplements.
The evidence to support nutrition intervention in patients receiving radiation therapy remains strong. However, the benefits of nutrition intervention in chemotherapy are less clear. Further studies are required to evaluate the impact of MNT as opposed to simple dietary advice in chemotherapy patients. This update contributes to a move towards comprehensive evidence-based guidelines for the nutritional management of patients with cancer.