Prospective trial on impact of oral nutritional supplements on elderly patients with nutritional risk after radical surgery for gastric cancer

Qiulei XI; Xinyi WANG; Shanjun TAN; Zhige ZHANG; Guohao WU

doi:10.19401/j.cnki.1007-3639.2025.10.001

您当前的位置：

首页 >

文章列表页 >

Prospective trial on impact of oral nutritional supplements on elderly patients with nutritional risk after radical surgery for gastric cancer

Specialist's Article | 更新时间：2025-12-31

- Prospective trial on impact of oral nutritional supplements on elderly patients with nutritional risk after radical surgery for gastric cancer
- China Oncology Vol. 35, Issue 10, Pages: 899-905(2025)
- 作者机构：
  
  1. 复旦大学附属中山医院普通外科胃肠外科，上海 200032
  2. 复旦大学附属中山医院临床营养科，上海 200032
- 作者简介：
- 基金信息：
- DOI：10.19401/j.cnki.1007-3639.2025.10.001
  CLC： R735.2
- Received：01 August 2025，
  
  Revised：2025-09-17，
  
  Published：30 October 2025
- 稿件说明：
移动端阅览
Qiulei XI, Xinyi WANG, Shanjun TAN, et al. Prospective trial on impact of oral nutritional supplements on elderly patients with nutritional risk after radical surgery for gastric cancer[J]. China Oncology, 2025, 35(10): 899-905.
DOI：

Qiulei XI, Xinyi WANG, Shanjun TAN, et al. Prospective trial on impact of oral nutritional supplements on elderly patients with nutritional risk after radical surgery for gastric cancer[J]. China Oncology, 2025, 35(10): 899-905. DOI： 10.19401/j.cnki.1007-3639.2025.10.001.

摘要

背景与目的：

营养不良和营养状况恶化在胃癌术后患者中较为常见，老年患者尤甚，严重影响患者的预后。研究显示，口服营养补充（oral nutritional supplements，ONS）可改善存在营养风险的胃癌术后出院患者的营养状况、改善患者的临床结局。本研究通过对前期随机对照临床试验中接受胃癌根治术的老年出院患者进行分析，探讨ONS对存在营养风险的老年胃癌术后出院患者的影响。

方法：

选取2017年1月—2018年12月在复旦大学附属中山医院就诊，存在营养风险并行接受胃癌根治术的出院患者，根据纳入和排除标准分为ONS组和对照组。对照组出院后3个月接受饮食建议，ONS组出院后3个月在饮食建议基础上联合ONS。出院后3个月比较两组患者的体重、体重指数（body mass index，BMI）、血红蛋白、血浆白蛋白及化疗耐受性。本研究的病例资料基于前期的1项随机对照临床试验（ChiCTR2000029708），获复旦大学附属中山医院伦理委员会批准（B2019-257R2）。

结果：

最终筛选出125例符合入组条件的患者，其中ONS组69例，对照组56例。通过3个月干预，两组患者体重、BMI、血红蛋白和血浆白蛋白水平差异均无统计学意义。然而，相比于对照组，ONS组在干预期间体重变化的下降幅度显著更小[（2.50±1.60）kg

（4.24±1.80）kg，

0.05

]

。相比于对照组，ONS组患者的化疗耐受性得到显著改善，总体化疗改变率下降（15.9%

41.1%，

=0.002），且化疗延迟，药物剂量减少及停止化疗的患者均少于对照组。多因素分析显示，体重、血浆白蛋白、血红蛋白、NRS2002、BMI对化疗正常进行的影响均不显著（

0.05）；只有ONS是显著的保护性因素，可显著降低化疗改变的发生风险（OR=0.227，

=0.001）。

结论：

ONS有助于提高老年胃癌术后出院患者的化疗耐受性并在一定程度上改善患者营养结局。对于存在营养风险的老年胃癌术后患者，出院后给予营养干预对改善患者的临床结局有积极意义。

Abstract

Background and purpose:

Malnutrition and deterioration of nutritional status are common in patients after surgery for gastric cancer

especially in the elderly

and severely affect patient prognosis. Studies have shown that oral nutritional supplements (ONS) can improve the nutritional status and clinical outcomes of patients after surgery for gastric cancer with nutritional risk. This study analyzed elderly patients who underwent radical surgery for gastric cancer in a previous randomized controlled trial to explore the impact of ONS on elderly patients after surgery for gastric cancer with nutritional risk.

Methods:

Patients discharged after gastric cancer radical surgery with nutritional risk who received treatment at Zhongshan Hospital affiliated with Fudan University from January 2017 to December 2018 were selected. The control group received dietary advice three months after discharge

while the ONS group received dietary advice combined with ONS three months after discharge. The weight

body mass index (BMI)

hemoglobin

plasma albumin

and chemotherapy tolerance of the two groups were compared three months after discharge. The data for this study was based on a previous randomized controlled trial (ChiCTR2000029708) which had received ethical approval. This study was approved by the Ethics Committee of Zhongshan Hospital Affiliated to Fudan University (B2019-257R2).

Results:

A total of 125 patients who met the inclusion criteria were finally selected

including 69 in the ONS group and 56 in the control group. After 3 months of intervention

there were no significant differences in weight

BMI

hemoglobin

and plasma albumin levels between the two groups. However

the ONS group showed a significantly smaller decrease in weight change during the intervention period compared to the control group [(2.50±1.60)kg

(4.24±1.80)kg

0.05

]

. The chemotherapy tolerance of the ONS group was significantly improved compared to the control group

with a decrease in the overall chemotherapy change rate (15.9%

41.1%

=0.002)

and fewer patients in the ONS group experienced chemotherapy delays

reduced drug dosages

and discontinuation of chemotherapy than those in the control group. Multivariate analysis showed that body weight

plasma albumin

hemoglobin

NRS2002

and BMI had no significant effect on the normal course of chemotherapy (

0.05); only ONS was a significant protective factor

significantly reducing the risk of chemotherapy modification (OR=0.227

=0.001).

Conclusion:

ONS helps improve the chemotherapy tolerance of elderly postoperative gastric cancer patients and to some extent enhances their nutritional outcomes. For elderly postoperative gastric cancer patients with nutritional risk

nutritional intervention after discharge has a positive impact on improving clinical outcomes.

关键词

Keywords

references

BRAY F , LAVERSANNE M , SUNG H , et al . Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries [J ] . CA Cancer J Clin , 2024 , 74 ( 3 ): 229 - 263 .

SMYTH E C , NILSSON M , GRABSCH H I , et al . Gastric cancer [J ] . Lancet , 2020 , 396 ( 10251 ): 635 - 648 . DOI: S0140-6736(20)31288-5 http://doi.org/S0140-6736(20)31288-5

中国研究型医院学会老年外科专业委员会 . 老年外科患者围手术期营养支持中国专家共识(2024版) [J ] . 中华消化外科杂志 , 2024 , 23 ( 5 ): 629 - 641 .

Chinese Research Hospital Association Geriatric Surgery Professional Committee . Chinese expert consensus on perioperative nutritional support for elderly surgical patients (2024 edition) [J ] . Chin J Dig Surg , 2024 , 23 ( 5 ): 629 - 641 .

WANG H M , WANG T J , HUANG C S , et al . Nutritional status and related factors in patients with gastric cancer after gastrectomy: a cross-sectional study [J ] . Nutrients , 2022 , 14 ( 13 ): 2634 . DOI: 10.3390/nu14132634 http://doi.org/10.3390/nu14132634 https://www.mdpi.com/2072-6643/14/13/2634 https://www.mdpi.com/2072-6643/14/13/2634

AKAD F , FILIP B , PREDA C , et al . Assessing nutritional status in gastric cancer patients after total versus subtotal gastrectomy: cross-sectional study [J ] . Nutrients , 2024 , 16 ( 10 ): 1485 . DOI: 10.3390/nu16101485 http://doi.org/10.3390/nu16101485 https://www.mdpi.com/2072-6643/16/10/1485 https://www.mdpi.com/2072-6643/16/10/1485

MUSCARITOLI M , ARENDS J , BACHMANN P , et al . ESPEN practical guideline: clinical nutrition in cancer [J ] . Clin Nutr J . 2021 , 40 ( 5 ): 2898 - 2913 .

中国抗癌协会胃癌专业委员会 , 中华医学会外科学分会胃肠外科学组 . 胃癌围手术期营养治疗中国专家共识(2019版) [J ] . 中国实用外科杂志 , 2020 , 40 ( 2 ): 145 - 151 .

Gastric Cancer Association of China Anti-Cancer Association, Gastrointestinal Surgery Group of the Chinese Medical Association Surgery Branch . Consensus of Chinese expert panel on perioperative nutrition therapy of gastric cancer (2019 edition) [J ] . Chin J Pract Surg , 2020 , 40 ( 2 ): 145 - 151 .

WEIMANN A , BEZMAREVIC M , BRAGA M , et al . ESPEN guideline on clinical nutrition in surgery-update 2025 [J ] . Clin Nutr , 2025 : 222 - 261 .

MENG Q Y , TAN S J , JIANG Y , et al . Post-discharge oral nutritional supplements with dietary advice in patients at nutritional risk after surgery for gastric cancer: a randomized clinical trial [J ] . Clin Nutr , 2021 , 40 ( 1 ): 40 - 46 . DOI: 10.1016/j.clnu.2020.04.043 http://doi.org/10.1016/j.clnu.2020.04.043

中华医学会老年医学分会 . 老年人营养不良防控干预中国专家共识(2022) [J ] . 中华老年医学杂志 , 2022 , 41 ( 7 ): 749 - 759 .

Chinese Medical Association Geriatrics Branch . Chinese Expert Consensus on Prevention and Control Intervention for Malnutrition in the Elderly (2022) [J ] . Chin J Geriatrics , 2022 , 41 ( 7 ): 749 - 759 .

PARK J Y , GEORGES D , ALBERTS C J , et al . Global lifetime estimates of expected and preventable gastric cancers across 185 countries [J ] . Nat Med , 2025 , 31 ( 9 ): 3020 - 3027 . DOI: 10.1038/s41591-025-03793-6 http://doi.org/10.1038/s41591-025-03793-6

DE VAN DER SCHUEREN M A E , LAVIANO A , BLANCHARD H , et al . Systematic review and meta-analysis of the evidence for oral nutritional intervention on nutritional and clinical outcomes during chemo(radio)therapy: current evidence and guidance for design of future trials [J ] . Ann Oncol , 2018 , 29 ( 5 ): 1141 - 1153 . DOI: S0923-7534(19)34566-1 http://doi.org/S0923-7534(19)34566-1

ZWART N R K , FRANKEN M D , TISSING W J E , et al . Folate, folic acid, and chemotherapy-induced toxicities: a systematic literature review [J ] . Crit Rev Oncol Hematol , 2023 , 188 : 104061 . DOI: 10.1016/j.critrevonc.2023.104061 http://doi.org/10.1016/j.critrevonc.2023.104061 https://linkinghub.elsevier.com/retrieve/pii/S104084282300149X https://linkinghub.elsevier.com/retrieve/pii/S104084282300149X

ANDERSON P M , THOMAS S M , SARTOSKI S , et al . Strategies to mitigate chemotherapy and radiation toxicities that affect eating [J ] . Nutrients , 2021 , 13 ( 12 ): 4397 . DOI: 10.3390/nu13124397 http://doi.org/10.3390/nu13124397 https://www.mdpi.com/2072-6643/13/12/4397 https://www.mdpi.com/2072-6643/13/12/4397

DE FREITAS J S , DE OLIVEIRA PEDRON É L , DE LIMA E SILVA ALIPRANDI J , et al . The effect of chemotherapy on dietary intake and nutritional status in patients with colorectal neoplasms and the importance of nutritional counseling [J ] . Support Care Cancer , 2022 , 30 ( 5 ): 3885 - 3891 . DOI: 10.1007/s00520-022-06794-0 http://doi.org/10.1007/s00520-022-06794-0

JOHARATNAM-HOGAN N , SHIU K K , KHAN K . Challenges in the treatment of gastric cancer in the older patient [J ] . Cancer Treat Rev , 2020 , 85 : 101980 . DOI: 10.1016/j.ctrv.2020.101980 http://doi.org/10.1016/j.ctrv.2020.101980 https://linkinghub.elsevier.com/retrieve/pii/S0305737220300189 https://linkinghub.elsevier.com/retrieve/pii/S0305737220300189

谈善军 , 严明月 , 张知格 , 等 . 营养治疗对胃癌根治术后营养不良患者短期疗效影响的前瞻性随机对照研究 [J ] . 中华消化外科杂志 , 2023 , 22 ( 11 ): 1337 - 1342 .

TAN S J , YAN M Y , ZHANG Z G , et al . A prospective randomized controlled study on the short-term efficacy of nutritional therapy in patients with malnutrition after radical gastrectomy for gastric cancer [J ] . Chin J Digest Surg , 2023 , 22 ( 11 ): 1337 - 1342 .

LI D N , SUN C L , KIM H , et al . Geriatric assessment-driven intervention (GAIN) on chemotherapy-related toxic effects in older adults with cancer: a randomized clinical trial [J ] . JAMA Oncol , 2021 , 7 ( 11 ): e214158 . DOI: 10.1001/jamaoncol.2021.4158 http://doi.org/10.1001/jamaoncol.2021.4158 https://jamanetwork.com/journals/jamaoncology/fullarticle/2784405 https://jamanetwork.com/journals/jamaoncology/fullarticle/2784405

KOBAYASHI D , ISHIGURE K , MOCHIZUKI Y , et al . Multi-institutional prospective feasibility study to explore tolerability and efficacy of oral nutritional supplements for patients with gastric cancer undergoing gastrectomy (CCOG1301) [J ] . Gastric Cancer , 2017 , 20 ( 4 ): 718 - 727 . DOI: 10.1007/s10120-016-0668-3 http://doi.org/10.1007/s10120-016-0668-3

CINTONI M , GRASSI F , PALOMBARO M , et al . Nutritional interventions during chemotherapy for pancreatic cancer: a systematic review of prospective studies [J ] . Nutrients , 2023 , 15 ( 3 ): 727 . DOI: 10.3390/nu15030727 http://doi.org/10.3390/nu15030727 https://www.mdpi.com/2072-6643/15/3/727 https://www.mdpi.com/2072-6643/15/3/727

HABIBI S , TALEBI S , KHOSRAVINIA D , et al . Oral nutritional supplementation in cancer patients: a systematic review and dose-response meta-analysis [J ] . Clin Nutr , 2025 , 47 : 28 - 39 . DOI: 10.1016/j.clnu.2025.02.011 http://doi.org/10.1016/j.clnu.2025.02.011

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

A study on the immunomicroenvironment characteristics of gastric cancer with neuroendocrine neoplasm and pure gastric cancer

Research progress and future perspectives of anticancer drug-induced interstitial lung disease/pneumonia in gastric cancer

Discovery and preliminary validation of five early gastric cancer biomarkers, including TAGLN2 and CTSD, based on serum proteomics

Artificial intelligence in gastric cancer diagnosis, treatment and prognostic prediction: current application and future perspective

Comparison and review of updated guidelines for advanced gastric cancer diagnosis and treatment in 2024: CSCO, NCCN and ESMO

Related Author

ZHANG Yi

SUN Haidong

QU Xinglong

ZHAO Bin

Xiaoyu GUO

Xiujuan QU

Kewei DU

Shangdi ZHANG

Related Institution

Seventh People’s Hospital Affiliated to Shanghai University of Traditional Chinese Medicine

Department of Surgical Oncology, Minhang Branch, Fudan University Shanghai Cancer Center

Department of Medical Oncology, The First Hospital of China Medical University

Laboratory Medicine Center, The Second Hospital & Clinical Medical School, Lanzhou University

Department of General Surgery, The Second Hospital & Clinical Medical School, Lanzhou University

AI问答

⁰