Optimizing Nutritional Support in Advanced Non-Small Cell Lung Cancer: Evidence and Controversies in Oral, Enteral, and Parenteral Approaches.

Malnutrition and cachexia affect the majority of patients with advanced lung cancer, driven by systemic inflammation (IL-6, TNF-α), metabolic dysregulation, and anorexia. These conditions worsen prognosis, reduce treatment tolerance, and diminish quality of life (QoL) and survival. Early recognition...

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Publicado en:Nutrition & Cancer Vol. 78; no. 4/5; pp. 265 - 279
Autores principales: Obomanu, Elvis, Ugwu, Chidiebube, Megiso, Muluken, Jones, Colton, Verinumbe, Tarfa, Ratnani, Akshay, King, Sam, Palaferro, Danielle, Hlaing, Swe Swe, Cohn, Zachary
Formato: algorithm review tables/charts Journal Article
Publicado: Taylor & Francis Ltd 2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 2026
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        10.1080/01635581.2026.2632656
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        atl: Optimizing Nutritional Support in Advanced Non-Small Cell Lung Cancer: Evidence and Controversies in Oral, Enteral, and Parenteral Approaches.
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          Obomanu, Elvis
          Ugwu, Chidiebube
          Megiso, Muluken
          Jones, Colton
          Verinumbe, Tarfa
          Ratnani, Akshay
          King, Sam
          Palaferro, Danielle
          Hlaing, Swe Swe
          Cohn, Zachary
        affil: Department of Internal Medicine, Jefferson-Einstein Hospital, Philadelphia, PA, USA
      sug:
        subj:
          Nutritional Support
          Carcinoma, Non-Small-Cell Lung Drug Therapy
          Enteral Nutrition
          Administration, Oral
          Parenteral Nutrition
          Dietary Supplements Therapeutic Use
          Cachexia Drug Therapy
          Quality of Life
          Appetite Stimulating Agents Therapeutic Use
          Inflammation Complications
          Patient Centered Care
          Palliative Care
          Deglutition Disorders Complications
          Gastrointestinal Motility
          Consent
          Cultural Diversity
          Healthcare Disparities
          Anorexia Complications
          Malnutrition Complications
          Nutritional Status
          Dietary Proteins Administration and Dosage
          Weight Gain
          Biological Markers Blood
          Infection Risk Factors
          Carcinoma, Non-Small-Cell Lung Prognosis
          Exercise
          Ethics, Medical
          Patient Autonomy
          Cultural Values
          Health Services Accessibility
          Appetite Physiology
          Biochemical Phenomena
          Adipose Tissue Distribution
          Muscle, Skeletal Physiology
          Immunity
          Functional Status
          Phenotype
          Dose-Response Relationship
          Chemoradiotherapy Adverse Effects
          Energy Metabolism
          Hydration Status
          Decision Making
          Advance Directives
          Muscle Strength
          Cytokines Blood
      ab: Malnutrition and cachexia affect the majority of patients with advanced lung cancer, driven by systemic inflammation (IL-6, TNF-α), metabolic dysregulation, and anorexia. These conditions worsen prognosis, reduce treatment tolerance, and diminish quality of life (QoL) and survival. Early recognition, utilizing tools such as the Patient-Generated Subjective Global Assessment (PG-SGA), is crucial. Nutritional support should align with patient-centered goals, prioritizing function and QoL rather than survival alone. Oral nutritional supplements (ONS), especially high-protein/EPA (eicosapentaenoic acid)- enriched formulas, enhance weight, muscle mass, and QoL but often face adherence challenges. Enteral nutrition (EN) supports patients with functional GI tracts and impaired intake (e.g., dysphagia), improving biomarkers and reducing complications. Parenteral nutrition (PN) should be limited to patients with intestinal failure due to infection risks and minimal survival benefits. Multimodal care, encompassing nutrition, exercise, and pharmacotherapy (e.g., appetite stimulants, investigational agents such as anamorelin), is crucial. Ethical, cultural, and legal considerations must guide decisions around artificial nutrition, emphasizing autonomy, informed consent, and respect for cultural beliefs. Barriers such as inconsistent screening and limited resources persist. Future research should focus on lung cancer-specific trials of EN, standardized cachexia definitions, and equitable access to nutritional support, especially in underserved populations.
      pubtype: Academic Journal
      doctype:
        algorithm
        review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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