Examining the Nutritional Status and Treatment Protocols of Patients with NSCLC

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Lung cancer is the leading cause of death from cancer and the second most common cancer in the United States.1 Lung cancer is often not diagnosed until it is in an advanced stage, as symptoms are either not exhibited until then or they are mistaken for other lung diseases.1 For patients with inoperable advanced non–small-cell lung cancer (NSCLC), treatment regimens include radiotherapy, immunotherapy, chemotherapy, and tyrosine kinase inhibitors. At the advanced stage, patients with NSCLC may also exhibit weight loss and/or cancer cachexia, which can be associated with lower survival time, lower quality of life, reduced immune function, and increased healthcare costs. It can also negatively impact treatment efficacy. Studies have demonstrated that cancer malnutrition can occur in 31% to 97% of patients, and the relative risk of death is 1.8 times higher in cancer patients who experience malnutrition. Chemotherapy poses an increased risk for patient malnutrition as patients frequently experience nausea and an alteration in taste. Patients with lung cancer at higher risk for malnutrition include smokers, those with prior poor nutritional status, elderly patients, and female patients. Improving nutritional status can help patients maintain a good quality of life and can improve treatment effectiveness. The nutritional status of patients with NSCLC should be included in treatment plans and appropriate nutritional support be provided.

Researchers conducted a study on lung cancer, treatment, and nutritional support using data from 82 patients with advanced NSCLC in Greece. The study included 42 patients with squamous-cell carcinoma and 40 patients with adenocarcinoma. There were 42 female patients and 40 male patients, with a mean age of 62 years for the females and 65 years for the males. Chemotherapy, radiotherapy, immunotherapy, or a combination of these therapies were administered to the patients. Nutritional measurements were collected and assessed, including body mass index and Mediterranean diet score. Also assessed were basic metabolism (resting metabolic rate [RMR]; kcal/day), number of years smoking, VO2 (mL/min), physical activity, and ventilation (L/min).

Patients treated with combined chemotherapy and immunotherapy demonstrated higher survival rates. The researchers noted an abrupt drop in RMR, which was speculated to be a result of patient stress while undergoing treatment. Severe weight loss was found in 7% of the patients in this study, with most patients losing weight after 6 months. VO2 and RMR had a negative association with the survival status of the patients. In patients treated with immunotherapy, the mean fat difference was higher than in patients treated with combined chemotherapy and immunotherapy.


Pilikidou M, Palyvou F, Papadopoulou SK, et al. Lung cancer, treatment and nutritional status. Mol Clin Oncol. 2021;15:248.


  1. American Cancer Society. Can lung cancer be found early? Updated August 27, 2021. www.cancer.org/cancer/lung-cancer/detection-diagnosis-staging/detection.html. Accessed March 25, 2022.

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