In China, the treatment of advanced-stage cancer often follows a pattern where the management of patients is primarily overseen by oncologists who focus on addressing the main clinical symptoms and intervening accordingly. However, symptoms such as appetite loss, weight loss, and anxiety are often overlooked. It is common for clinical nutritionists to passively enter oncology wards to conduct comprehensive nutritional assessments and develop nutrition plans only when patients exhibit significant malnutrition, upon request from oncologists or patients and their families. Against this background, the investigators integrated clinical nutritionists into the oncology treatment team and established a proactive nutritional intervention team specifically targeting stage IV cancer patients. This initiative aims to conduct a single-center, open-label, randomized parallel-group prospective study, with the following objectives: 1) to evaluate the impact of this model on the nutritional status, survival, and quality of life of advanced-stage cancer patients, and 2) to further optimize this model for widespread replication in clinical practice.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
SINGLE
Enrollment
158
This involves a multidisciplinary team intervention, including oncologists, nutritionists, and nurses. Additionally, the intervention introduces a team-developed mobile application (APP) for the purpose of regular patient follow-ups to identify nutritional risks promptly and facilitate timely interventions. Patients identified as at risk through the app follow-up will be referred to the nutrition clinic for consultation to address nutritional concerns. For advanced-stage cancer patients undergoing monthly chemotherapy hospitalizations, comprehensive assessments encompassing nutrition, psychological aspects, and other facets will be conducted during hospital stays. When deemed necessary, patients will receive dietary guidance and nutritional support.
West China Hospital, Sichuan Universit
Chengdu, Sichuan, China
the incidence of cachexia
The definition and classification of cancer cachexia was used by an international consensus \[9, 10\]: (1) weight loss \> 5% over the past 6 months (in the absence of simple starvation), (2) BMI \< 20 and any degree of weight loss \> 2%, or (3) appendicular skeletal muscle index consistent with sarcopenia and any degree of weight loss \> 2%. The assessment of skeletal muscle depletion was used by mid-upper arm muscle area by anthropometry (men \< 32 cm2, women \< 18 cm2)
Time frame: every month, up to half year
body weight
Changes in body weight over 6 months
Time frame: every month, up to half year
Nutritional risk and malnutrition status
Nutrition Risk Screening 2002 (NRS2002) ，the minimum value is 0 and maximum value is 7, and higher scores mean a worse outcome.
Time frame: every month, up to half year
Nutritional risk and malnutrition status
Patient-Generated Subjective Global Assessment (PG-SGA)，the minimum value is 0 and maximum value is 20, and higher scores mean a worse outcome.
Time frame: every month, up to half year
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