1. Results Conclusions Objective & Hypothesis Background Acknowledgements: Methodology Data Analysis from Clinical Research Trials Western Kentucky University College of Health and Human Services Allison Rahman --allison.rahman990@topper.wku.edu Zachary Clark --zachary.clark521@topper.wku.edu Lauren Shivers --lauren.shivers747@topper.wku.edu Contact Information Dr. Maggie Cook-Newell Family and Consumer Scienecs College of Health and Human Services Western Kentucky University Akbulut, Gazme, Experimental and Therapeutic Medicine (2011); Baldwin, C., et Al, Journal of Human Nutrition and Dietetics (2011); Garth, A.K., et. Al, Journal of Human Nutrition and Dietetics (2010); Hasenberg, T, et. Al, Colorectal Disease ( 2010); Mason, J. B., Principles and Practices of Gastrointestinal Oncology Second Edition (2008); Mutlu, Ece A., et. Al, Nutrition in Clinical Care (2000); Read JA, et. Al, Support Care Cancer (2007); Tong, H., et. Al, Supportive Care Cancer (2009) © 2011 Western Kentucky University. Printing paid from state funds, KRS 57.375 Western Kentucky University is an equal opportunity institution of higher education and upon request provides reasonable accommodation to individuals with disabilities. www.wku.edu/eoo The Effects of Nutrition Support on Malnourished Gastrointestinal Cancer Patients Receiving Chemotherapy The main focus of our study was to find evidence that patients receiving nutritional support, whether total parenteral nutrition (TPN) or enteral nutrition (EN) responded to chemotherapy more effectively than patients not receiving nutrition support. Three specific objectives/aims emerged from the literature and are as follows: 1.Effect of malnutrition on GI cancer patients. 2.The benefits of medical nutrition therapy on GI cancer patients receiving chemotherapy. 3.Provide evidence that nutrition support for malnourished gastrointestinal cancer patients respond more positively to the treatment. HYPOTHESIS: Nutrition support given to malnourished GI cancer patients benefited more from chemotherapy than those that do not receive any type of NS. PROBLEM OF STUDY: Gastrointestinal (GI) cancer patients who experience gastrointestinal mal-absorption, loss of appetite and decreased intake due to chemotherapy side effects or disease related can lead to a malnourished state, and may not receive the full dose of chemotherapy required. SIGNIFICANCE: The significance of this research study was to find options that would help malnourished gastrointestinal cancer patients respond better to chemotherapy so that they could receive adequate doses of chemotherapy and improve quality of life. The research design was a double blind study involving 50 GI cancer patients undergoing chemotherapy. The age group consisted of those between 25 to 50 years of age. Following the IRB approval, we obtained consent from those willing to participate in the study. Before the research began, the administration of a Malnourishment Screening tool was given on each participant. For the first three months of the study each patient was monitored every three weeks based on nourishment, quality of life and effects of chemotherapy. Following the three month mark of the study, each patient was monitored every six weeks of the remaining year to track their behavior. The study lasted approximately one year from the time of IRB approval. 50 patients, aged 28-50 years, were enrolled. 39 completed 6 months and 28 completed all 12 months. Of patients who underwent the malnutrition screening tool, 32% were classified as mild-moderately malnourished and 16% severely malnourished. There was a significant increase in mean weight (4.0 kg) at 6 weeks with those on parenteral nutrition (PN) or enteral nutrition (EN). Lean body mass (LBM) was maintained. There was a significant increase in energy levels while all other QOL measures were maintained. Chemotherapy- associated side effects were higher in PN. There was no difference in the survival rate between patients who used PN or EN. Symptom prevalence was determined by the proportion of patients experiencing at least one nutrition impact symptom from chemotherapy was 79% and 72% at 1 and 6 months after starting nutrition therapy. Even at 12 months, symptom prevalence was 46%. The most common symptoms included dry mouth, nausea, and constipation with the most distressing symptoms reported as dry mouth, diarrhea, and stomach pain. In our findings whether nutrition support in malnourished cancer patients enhanced the therapeutic effects of chemotherapy ended inconclusively. To decide upon such a conclusion, several of the studies that were reviewed resulted without enough evidence to fully state that nutrition support in malnourished gastrointestinal cancer patients benefited more therapeutically from chemotherapy treatment than those that did not receive any nutritional intervention. The evidence that was found to partially support our research theory was that weight gain positively affected patients undergoing chemotherapy than those that did not, but to state that malnourished patients benefited therapeutically involved a number of variables that were not recognized before the study began. Another factor that drew to this conclusion were previous research literatures that contradicted our theory rather than supporting it. Although, further identifying possible modifications to the nutrition support diets and the mode of nutrition support used in certain cases increases the chance that nutrition support benefits the malnourished GI cancer patient, and that our scope of research was too broad. Research Study ResourceSupported the HypothesisEnded InconclusivelyContradicted the Hypothesis Akbulut, Gazme ✔ Baldwin, C., et. al ✔ Garth, A.K., et. al ✔ Hasenberg, T., et. al ✔ Mason, J.B. ✔ Mutlu, Ece A, et. al ✔ Read, JA, et. al ✔ Tong, H., et. al ✔