The Clinical Benefits of Nutritional Supplementation Across the Chemotherapy Journey in Cancer Patients: A Multicenter Prospective Cohort Study

PURPOSE: This study aimed to explore the clinical benefits of receiving nutritional supplementation (NS) throughout the whole course of chemotherapy. METHODS: This multicenter prospective cohort study totally included 251 cancer patients requiring nutritional support and scheduled for chemotherapy. Primary outcomes included energy intake (EI), protein intake (PI), body mass index (BMI), NRS 2002 and PG-SGA scores. Short-term efficacy was the secondary outcome. RESULTS: Among the study participants, 168 received NS, whereas 83 opted for dietary advice (DA) alone. In the NS group, EI and PI demonstrated a gradual upward trend across the six cycles of chemotherapy, with no significant changes in the DA group. The BMI remained stable in both groups. The proportion of patients with or at risk of malnutrition showed a declining trend in the NS group but an increasing trend in the DA group. The generalized estimating equation results indicated that NS significantly improved PI (coefficient = 0.19, 95% CI: 0.11 to 0.27, p < 0.001), NRS 2002 (coefficient = -0.13, 95% CI: -0.23 to -0.03, p = 0.005), and PG-SGA (coefficient = -0.18, 95% CI: -0.28 to -0.08, p < 0.001). The improvements in PI, NRS 2002, and PG-SGA scores occurred from cycle 1, cycle 3, and cycle 2, respectively. Multivariate logistic analysis confirmed NS as a favorable factor associated with higher disease control rate (OR = 4.65, 95% CI: [1.88, 12.01], p = 0.001). CONCLUSIONS: The incorporation of NS yielded several clinical benefits beyond adequate EI and stable weight. It contributes to higher protein intake and good nutritional status in patients with cancer throughout the whole course of chemotherapy, ultimately improving treatment efficacy. TRIAL REGISTRATION: Patient-Reported Outcome Management Including Surveillance and Intervention in Nutritional Group (PROMISING) Study (registration number: ChiCTR2100047535).