Lifestyle-medicine strategy for improving outcome of cancer patients (LIOC): study protocol for a real-world cohort study

Background: Malignant tumor is one of the major clinical and public health problems in China and worldwide. It adversely affects the survival and quality of life of affected patients and causes enormous medical and economic burdens. Lifestyle-Medicine Strategy for Improving Outcome of Cancer Patients (LIOC) is jointly initiated by the Chinese Association of Parenteral and enteral Nutrition Branch and the Professional Committee of Tumor Nutrition of the Chinese Anti-Cancer Association. Its overarching goal is to evaluate whether lifestyle-medicine intervention can augment the effect of anti-tumor treatment and improve the quality of life and survival time of cancer patients. Methods: LIOC is a multi-center, real-world, multi-disciplinary, health care model for cancer patients. Eligible cancer patients are those who meet inclusion and exclusion criteria and who provided informed consent to participate. LIOC will collect patients’ multi-dimensional data such as medical conditions and related clinical data, disease treatment plans, complications, diet, nutrition supplement, physical activity, psychological stress, sleep, eating habits, and behavior habits by means of both in-hospital and out-of-hospital parallel methods. LIOC also collects biospecimen (blood, stool, tumor mucosal tissues) at the specified time points. These samples will be used for multi-omics analysis such as genome and metabolome of the gut microbiota. LIOC employs advanced statistical methods and artificial intelligence (AI) to organize and analyze data and to develop more precise and effective strategies for personalized diet, nutrition, physical activity, stress reduction, sleep, and complication warning. The LIOC team includes physicians, oncologists, nutritionists, dietitians, nurses, and researchers who work collaboratively to improve the outcomes of cancer patients. Results: LIOC is the first real-world health care model through a hospital-community-home Linkage management approach and collects and harnesses longitudinal, multi-dimensional data for evaluation and management of cancer patients in China. The LIOC can provide more precise and personalized intervention programs for cancer patients, which can further improve clinical outcomes and quality of life for patients. Conclusions: The LIOC provides full life cycle nutrition management for cancer patients. It is an iterative process powered by the advanced data collection platform and AI, starting from analyzing cancer patients’ nutritional and lifestyle factors and needs, which informs individually tailored lifestyle-medicine intervention, followed by evaluation of the experience and effect of the intervention.