Akademik Veri Yönetim Sistemi
SUPPORTIVE CARE IN CANCER, cilt.33, sa.775, ss.1-17, 2025 (SCI-Expanded)
Abstract
Objectives This study aimed to evaluate the effects of high-protein oral nutritional supplements (ONS) on nutritional status,
physical function, and quality of life in older gastric cancer patients undergoing neoadjuvant chemotherapy (NAC).
Methods A prospective, randomized controlled trial was conducted between February 2023 and February 2024, including
46 patients aged 65 or older with newly diagnosed, locally advanced gastric cancer. Participants were randomized into two
groups: an intervention group receiving high-protein ONS in addition to standard nutrition care, and a control group receiving
only standard nutrition care. Nutritional status was assessed using the Mini Nutritional Assessment (MNA), physical
function was evaluated through handgrip strength, Activities of Daily Living (ADL), and Instrumental Activities of Daily
Living (IADL) scales, and health-related quality of life was measured using the EORTC QLQ-C30. Bioelectrical impedance
was used to analyze body composition.
Results Among the 46 patients (23 in each group), baseline characteristics were similar between the groups (p > 0.05). The
ONS group showed significantly higher energy and protein intake than the control group (p < 0.05). MNA scores improved
significantly in the ONS group after 8 weeks (p < 0.001), with a reduction in malnutrition risk to 4.3%, compared to 17.4%
in the control group (p = 0.003). ADL and IADL scores remained stable in both groups, and both groups reduced functions
and increased symptoms of HRQL over 8 weeks. Emotional functioning scores significantly declined in both groups over the
8-week period (ONS group: from 91.7 [16.67] to 83.3 [8.33], p = 0.001; non-ONS group: from 91.7 [8.33] to 83.3 [16.67],
p = 0.011). Fatigue levels also increased markedly in both groups (ONS: from 11.1 [11.11] to 49.3 ± 17.02; non-ONS: from
22.2 [11.11] to 44.4 [22.22], p < 0.001). Additionally, constipation symptoms worsened significantly in the non-ONS group
by week 8 (p = 0.008).
Conclusions High-protein ONS improved nutritional status and reduced malnutrition risk in older gastric cancer patients
undergoing NAC. Further research is needed to assess the long-term effects of ONS on physical function and quality of life.
Trial registration Registered under ClinicalTrials.gov Identifier no. NCT06645912.
Keywords Gastric cancer · Older patients · Oral nutritional supplement