Interprofessional Team-Based Whole-Course Enteral Nutrition in the Peri-Radiation Therapy Period for Esophageal Cancer.

Interprofessional Team–Based Whole-Course Enteral Nutrition in the Peri–Radiation Therapy Period for Esophageal Cancer - PMC Skip to main content An official website of the United States government Here's how you know Here's how you know Search Log in Primary site navigation Search Log in Search PMC Full-Text Archive Search in PMC Journal List User Guide As a library, NLM provides access to scientific literature. Inclusion in an NLM database does not imply endorsement of, or agreement with, the contents by NLM or the National Institutes of Health. Learn more: PMC Disclaimer | PMC Copyright Notice Clin J Oncol Nurs . 2025 Jun 1;29(3):E88–E96. doi: 10.1188/25.CJON.E88-E96 Interprofessional Team–Based Whole-Course Enteral Nutrition in the Peri–Radiation Therapy Period for Esophageal Cancer Yuntian Shen 1 , Yawen Zhu 1 , Xiaoxiao Liu 1 , Wenyi Lu 1 , Xiaoli Wang 1 , Xinan Shen 1 , Qiliang Peng 1 , Yuezhen Feng 1, ✉ Author information Article notes Copyright and License information 1 Yuntian Shen, PhD, MD, is a deputy chief physician in the Department of Radiotherapy and Oncology, Yawen Zhu, BSN, RN, is a head nurse, and Xiaoxiao Liu, BSN, RN, Wenyi Lu, BSN, RN, and Xiaoli Wang, BSN, RN, are nurses, all in the Department of Nursing, Xinan Shen, BS, is a student and Qiliang Peng, PhD, MD, is an attending physician, both in the Department of Radiotherapy and Oncology, and Yuezhen Feng, BSN, RN, is a head nurse in the Department of Nursing, all at the Second Affiliated Hospital of Soochow University in Suzhou, China. ✉ Feng can be reached at fengyuezhen0611@163.com , with copy to CJONEditor@ons.org . Y. Shen, Zhu, and Liu are dual first authors ✉ Corresponding author. Received 2024 Feb 1; Accepted 2025 Jan 8; Collection date 2025 Jun. Copyright 2025 by the Oncology Nursing Society Single-user license only. ONS reserves all rights. For permission to post online, reprint, adapt, or reuse, please email pubpermissions@ons.org . PMC Copyright notice PMCID: PMC12124878  PMID: 40401829 Abstract BACKGROUND Radiation therapy is the main treatment method for esophageal cancer, but its side effects are not ideal. The interprofessional team (IPT) management model has been widely applied in clinical practice; however, there are few reports on nurse-led IPT-based enteral nutrition intervention strategies for patients with esophageal cancer. OBJECTIVES A nurse-led, IPT-based, whole-course enteral nutrition intervention was investigated to determine whether it could achieve better nutritional status, quality of life, and treatment efficacy for patients with esophageal cancer. METHODS A total of 72 patients with esophageal cancer were randomized to control and IPT groups. Nutritional status, quality of life, and treatment efficacy were observed before and after radiation therapy. FINDINGS Severe malnutrition and grade 3 or higher bone marrow suppression had significantly lower incidence, and the one-year progression-free and overall survival rates of patients were significantly higher in the IPT group than the control group. Keywords: esophageal cancer, enteral nutrition, interprofessional, peri-radiation therapy IN 2022, THERE WERE 510,716 NEW CASES and 445,129 deaths worldwide from esophageal cancer ( Bray et al., 2024 ). Radiation therapy remains the main treatment method for patients with inoperable esophageal cancer ( Xia & Chen, 2023 ). Some studies show that about 60%–80% of patients with esophageal cancer experience malnutrition ( Li et al., 2020 ; Movahed et al., 2020 ), which can increase significantly during radiation therapy ( Chen et al., 2021 ; Muscaritoli et al., 2021 ). Malnutrition leads to weight loss, which, in turn, increases the positioning error and reduces the accuracy and completion rate of radiation therapy, increases the incidence of toxic side effects, and affects treatment efficacy. Based on existing research results and relevant guidelines, interprofessional teams (IPTs) in oncology can implement standardized, effective enteral nutrition (EN) management for patients receiving radiation therapy for esophageal cancer ( Liu et al., 2022 ; Wang et al., 2023 ; Zhang et al., 2022 ). EN is a nutritional support method that provides metabolic and other nutrients through the gastrointestinal tract. However, patients with esophageal cancer often have complex conditions and long treatment cycles across the peri–radiation therapy period. Challenges in implementing EN management, including nonstandard nutrition management, shortage of medical personnel, and inadequate coordination and communication between clinicians and patients, make it difficult to meet patients’ nutritional needs ( Mühlenpfordt et al., 2020 ; Salas et al., 2022 ; Wang et al., 2023 ). The IPT management model has been widely applied in clinical practice, but there are few reports on how to efficiently, quickly, and fully standardize EN interventions for patients with cancer during radiation therapy. Because of their close contact with patients, nurses can quickly initiate nutritional screening, organize IPTs to develop optimal nutritional intervention strategies, implement and dynamically adjust nutritional intervention plans, and provide comprehensive nutritional management in various environments, including hospitals, homes, and communities. This study explores the impact of whole-course EN using nurse-led IPTs over the entire treatment period, including inpatient and outpatient care, on the nutritional status, treatment efficacy, and quality of life of patients with esophageal cancer receiving radiation therapy. Methods Sample, Setting, and Ethical Approval The study site at the Second Affiliated Hospital of Soochow University in Suzhou, China, sees about 1,200 new patients each year for inpatient and outpatient care, among whom about 100 patients each year have esophageal cancer. Of patients with esophageal cancer seen at the study site between July 2, 2021, and April 30, 2023, 72 met the inclusion and exclusion criteria. The team divided these patients into the following two groups according to the random number table grouping method using IBM SPSS Statistics, version 22.0: the control group (conventional nursing) and the IPT group (IPT-based, nurse-led, whole-course EN intervention), with 36 patients in each group. The inclusion criteria were as follows: (a) having histopathologic confirmation of esophageal cancer, (b) being aged 18–90 years, (c) having a Karnofsky Performance Status Scale score of 60 or greater, (d) planning to undergo radiation therapy, (e) having stable conditions with no barriers to communication, and (f) having healthy or partially healthy heart, lung, liver, kidney, bone marrow, and gastrointestinal function. Exclusion criteria were as follows: (a) having severe gastrointestinal bleeding or bowel obstruction, (b) having severe gastrointestinal reactions or not tolerating EN, (c) having stage IV cancer with distant lymph node metastasis or hematologic metastasis beyond the area, or (d) having uncontrolled epilepsy, central nervous system disorders, or mental disorders whose treatment outcomes cannot be predicted. This study was approved by the ethics committee of the Second Affiliated Hospital of Soochow University (approval number: JD-LK-2021-025-010). All patients received written and oral information regarding the research objectives prior to the study. Procedures Within 24 hours of admission, nurses conducted nutritional risk screening on patients using the Nutritional Risk Screening 2002 system developed by the European Society for Clinical Nutrition and Metabolism ( Kondrup et al., 2003 ). Nurses reevaluated patients with Nutritional Risk Screening 2002 scores of 3 or higher using the Patient-Generated Subjective Global Assessment recommended by the American Nutrition Association ( Bauer et al., 2002 ). The control group had a nutritional intervention plan based on the opinions of physicians and relevant departments, and the intervention group (IPT group) was led by nurses who developed an EN plan and implemented whole-course EN management (see Table 1 ). TABLE 1. EN PLANS FOR CONTROL AND INTERVENTION GROUPS (N = 72) TOPIC CONTROL (N = 36) INTERVENTION (N = 36) Team composition Radiation therapy specialists contact nutritionists, gastroenterologists, and interventional physicians as needed. Head nurse establishes an IPT consisting of radiation therapy, nutrition, gastrointestinal surgery, interventional physicians, and nurses. Head nurse develops unified, standardized EN standards. Screening/assessment Nurses evaluate hospitalized patients and report scores of 3 or higher on the Nutritional Risk Screening 2002 to physicians. Nurses evaluate hospitalized patients and immediately initiate IPTs for patients with Nutritional Risk Screening 2002 scores of 3 or higher. Program development/implementation Physicians evaluate and develop EN intervention plans and conduct assessments and adjustments. Nurses summarize IPT opinions, develop EN intervention plans, and standardize the process of tube feeding and maintenance. Quality control Physicians evaluate patients’ nutritional indicators, adjust nutritional treatment plans, and modify medical orders. Nurses standardize management of EN implementation, including prevention and treatment of complications during tube feeding process. When patient intake does not meet 60% for 3–5 days, or if nutritional indicators continue to decline, restart IPT and adjust the treatment plan. Home EN After evaluating the patient’s nutritional status, the physician develops a family nutrition plan and provides guidance on home EN. Nurses assess the patient’s nutritional status and feeding ability on discharge and develop a family nutrition plan. Patients with nutritional risk or radiation esophagitis of less than grade 2 receive guidance about diet and oral nutritional supplementation. Patients with esophagitis of grade 3 or higher receive a nasogastric feeding tube and home EN support with an established home EN record. 3 days before discharge, nurses provide relevant education, practical training, and assessment on home EN to caregivers. Nurses establish personal contact groups with family members or patients, regularly provide education, assess nutritional status in a timely manner, and solve problems in the family’s EN process. Follow-up after discharge Physicians conduct follow-up visits in the outpatient department every 2 weeks, or once per month for patients with stable nutritional status. Nurses conduct follow-up visits in the outpatient department every 2 weeks, or once per month for patients with stable nutritional status. Open in a new tab EN—enteral nutrition; IPT—interprofessional team Data Collection and Analysis Primary end points were changes in malnutrition levels (Patient-Generated Subjective Global Assessment score, body mass index, and weight loss rate). Secondary end points were changes in serum albumin, serum prealbumin, and hemoglobin; the efficacy of radiation therapy; quality of life; and overall survival (OS) and progression-free survival (PFS) rates, with follow-up deadlines by June 30, 2023. The rate of early nutritional support (initiation time of less than 24 hours) ( Kreymann et al., 2006 ), duration of nutritional intervention, and intake adherence rate (calorie intake of 70% of recommended intake or greater) were also assessed. Radiation-induced dermatitis and esophagitis were graded according to the Radiation Therapy Oncology Group criteria for the evaluation of adverse events from radiation therapy ( Bots et al., 2017 ). The team assessed quality of life before and after radiation therapy using the European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaire–Core 30 (EORTC QLQ-C30). The study team used IBM SPSS Statistics, version 22.0, for data analysis, describing continuous variables with means and SDs and categorical variables with frequencies, with p < 0.05 indicating statistical significance. In addition, intergroup comparisons were performed using chi-square tests, t tests, rank-sum tests, and Kaplan–Meier estimates, with p < 0.05 indicating statistical significance. Results A total of 72 patients met the inclusion and exclusion criteria in this study. Between July 2, 2021, and June 30, 2022, 3 cases of deleted data and 11 cases of death data occurred in the control group, and 2 cases of deleted data and 3 cases of death data occurred in the IPT group. There were no statistically significant differences between groups in age, sex, body mass index, serum albumin, serum prealbumin, hemoglobin, disease stage, or Patient-Generated Subjective Global Assessment scores before radiation therapy (see Table 2 ). TABLE 2. BASELINE CHARACTERISTICS (N = 72) CHARACTERISTIC CONTROL (N = 36) INTERVENTION (N = 36) STATISTIC 95% CI p X̄ SD X̄ SD Age (years) 71.72 9.28 72.5 8.44 −0.374 a [70.05, 74.17] 0.711 Body mass index (kg/m 2 ) 21.43 3.31 20.5 3.2 1.214 a [20.2, 21.74] 0.229 Hemoglobin (g/L) 115.11 19.9 118.53 16.31 −0.797 a [112.54, 121.08] 0.428 Serum albumin (g/L) 40.62 5.18 39.42 4.66 1.034 a [38.86, 41.18] 0.305 Serum prealbumin (g/L) 0.176 – 0.158 – −1.615 b [0.154, 0.181] 0.106 CHARACTERISTIC n n STATISTIC 95% CI p Gender 0.693 c [0.649, 0.856] 0.405 Female 7 10 Male 29 26 Cancer stage −1.263 b [0.059, 0.224] 0.207 I – 1 II 3 5 III 19 20 IV 14 10 PG-SGA © score −0.863 b [0.604, 0.821] 0.388 Less than 4 19 15 4–8 8 10 More than 8 9 11 Open in a new tab a t b Z c γ 2 CI—confidence interval; PG-SGA—Patient-Generated Subjective Global Assessment Early Intervention Rate, Duration, and Intake Adherence The early intervention rate (initiation in less than 24 hours) in the IPT group (n = 36) was higher than in the control group (n = 16) (p < 0.001). The duration of nutritional intervention in the IPT group was higher than in the control group at one month (4–8 weeks), two months (8–12 weeks), and three months (more than 12 weeks) after radiation therapy (p < 0.001). The intake adherence rate of IPT group participants (n = 32) was also higher than that of the control group (n = 17) (p < 0.05) (see Table 3 ). TABLE 3. TIME TO INTERVENTION, DURATION, AND INTAKE ADHERENCE COMPARED BETWEEN GROUPS VARIABLE CONTROL (N = 36) INTERVENTION (N = 36) STATISTIC 95% CI p n n Time to intervention (hours) 27.692 a [0.308, 0.64] < 0.001 Less than 24 16 36 24 or greater 20 – Duration (weeks) −5.563 b [0.34, 0.599] < 0.001 Less than 4 16 2 4–8 15 6 8–12 3 6 More than 12 2 22 Intake adherence (% recommended calorie intake) 14.374 a [0.033, 0.382] < 0.001 Less than 70 19 4 70 or greater 17 32 Open in a new tab a γ 2 b Z CI—confidence interval Nutritional Indicators The malnutrition status of the IPT group after treatment was significantly better than that of the control group according to a variety of indicators. In the IPT group, 29 participants experienced weight loss of less than 5%, which was better than in the control group, where only 19 participants experienced weight loss of less than 5% (p < 0.05). The average laboratory indicators of participants in the IPT group (serum albumin = 40.24 [SD = 6.19], serum prealbumin = 0.18 [SD = 0.06], hemoglobin = 116.61 [SD = 13.44]) were superior to those in the control group (serum albumin = 36.63 [SD = 5.13], serum prealbumin = 0.13 [SD = 0.06], hemoglobin = 107.28 [SD = 16.63]). The differences were statistically significant (p < 0.05), as shown in Table 4 . TABLE 4. NUTRITIONAL INDICATORS COMPARED BETWEEN GROUPS VARIABLE CONTROL (N = 36) INTERVENTION (N = 36) STATISTIC 95% CI p X̄ SD X̄ SD Body mass index (kg/m 2 ) 20.45 3.46 20.07 3.32 0.472 a [19.47, 21.06] 0.638 Hemoglobin (g/L) 107.27 16.63 116.61 13.44 −2.619 a [108.25, 115.64] 0.011 Serum albumin (g/L) 36.63 5.13 40.24 6.19 −2.669 a [37.04, 39,83] 0.009 Serum prealbumin (g/L) 0.13 0.06 0.18 0.06 −3.406 a [0.143, 0.174] 0.001 VARIABLE n n STATISTIC 95% CI p PG-SGA © score 3.154 b [0.531, 0.761] 0.002 Less than 4 6 17 4–8 12 12 More than 8 18 7 Weight loss (% body weight) 6.25 c [0.227, 0.454] 0.012 Less than 5 19 29 5 or greater 17 7 Open in a new tab a t b Z c γ 2 CI—confidence interval; PG-SGA—Patient-Generated Subjective Global Assessment Survival Analysis The number of patients with radiation therapy interruption in the IPT group (n = 10) was lower than in the control group (n = 23) (p < 0.05). The one-year PFS rates of patients in the intervention and control groups were 84.5% (SD = 7.5%) and 61.8% (SD = 7.1%), respectively (p = 0.03), and the one-year OS rates of patients in the intervention and control groups were 90.1% (SD = 5.4%) and 70.6% (SD = 8.5%), respectively (p = 0.024). The local control and survival rates in the IPT group were significantly better than in the control group, as shown in Figure 1 and Table 5 . FIGURE 1. Open in a new tab SURVIVAL FUNCTION CURVES COMPARING OS AND PFS BETWEEN GROUPS OS—overall survival; PFS—progression-free survival TABLE 5. TREATMENT EFFICACY AND COMPLETION STATUS COMPARED BETWEEN GROUPS VARIABLE CONTROL (N = 36) INTERVENTION (N = 36) γ 2 95% CI p X̄ SD X̄ SD Survival at 1 year (%) Overall survival 70.6 8.5 90.1 5.4 5.118 [9.854, 12.91] 0.024 Progression-free survival 61.8 7.1 84.5 7.5 4.724 [5.972, 8.973] 0.03 VARIABLE n n γ 2 95% CI p Patient treatment status 9.455 [0.34, 0.58] 0.002 Interrupted 23 10 Uninterrupted 13 26 Interruptions to radiation therapy 41.427 [0.034, 0.052] < 0.001 Uninterrupted times 947 984 Interrupted times 72 13 Open in a new tab CI—confidence interval Severe Adverse Events The incidence of grade 3 or higher bone marrow suppression in the IPT group (n = 3) was significantly lower (p < 0.05) than that in the control group (n = 10). In addition, the incidence of grade 3 or higher radiation-induced dermatitis in the IPT group (n = 3) was lower than in the control group (n = 5), and the incidence of grade 3 or higher radiation-induced esophagitis in the IPT group (n = 6) was lower than in the control group (n = 10), but these differences were not statistically significant (see Table 6 ). TABLE 6. ADVERSE EVENTS COMPARED BETWEEN CGROUPS GRADE CONTROL (N = 36) INT (N = 36) γ 2 95% CI p n n Myelosuppression 4.6 [0.1, 0.289] 0.032 Less than 3 26 33 3 or greater 10 3 Dermatitis 0.563 [0.793, 0.951] 0.453 Less than 3 31 33 3 or greater 5 3 Esophagitis 1.286 [0.664, 0.867] 0.257 Less than 3 26 30 3 or greater 10 6 Open in a new tab CI—confidence interval; int—intervention Note . Grading is based on Radiation Therapy Oncology Group criteria for adverse events. Quality of Life There was no statistically significant difference in EORTC QLQ-C30 scores between the two groups before radiation therapy. The quality-of-life scores of the two groups of patients met the inclusion criteria. The EORTC QLQ-C30 total and domain scores of the IPT group after radiation therapy were significantly better than those of the control group (p < 0.05) (see Table 7 ). TABLE 7. WILCOXON RANK SUMS OF EORTC QLQ-C30 PARTICIPANT SCORES FOR QUALITY OF LIFE COMPARED BETWEEN GROUPS DOMAIN BEFORE RADIATION THERAPY Z p AFTER RADIATION THERAPY Z 95% CI p CTRL (N = 36) INT (N = 36) CTRL (N = 36) INT (N = 36) Cognitive 1,308 1,320 −0.073 0.942 931.5 1,696.5 −4.639 [82.66, 90.02] < 0.001 Emotional 1,274.5 1,353.5 −0.467 0.641 1,002 1,626 −3.677 [75.95, 80.53] < 0.001 Physical 1,190.5 1,427.5 −1.458 0.154 1,093 1,534.5 −2.563 [78.35, 85.54] 0.01 Role 1,248 1,380 −0.88 0.379 939 1,688.5 −4.477 [71.39, 80.23] < 0.001 Social 1,230.5 1,397.5 −1.1 0.271 1,127 1,501 −2.516 [62.22, 70.49] 0.012 Overall 1,219 1,409 −1.127 0.26 1,008 1,619.5 –3.558 [47.38, 53.31] < 0.001 Open in a new tab CI—confidence interval; ctrl—control; EORTC QLQ-C30—European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaire–Core 30; int—intervention Discussion This study explored the effects of nurse-led IPT EN care on the nutritional status, treatment efficacy, and quality of life of patients with esophageal cancer in the peri–radiation therapy period. For standard care in China, nutritional intervention is led by physicians, who may spend much time determining tumor treatment plans and may not be able to screen patients for malnourishment, coordinate relevant departments, and develop nutritional intervention plans in a timely manner. Physicians may find it difficult to manage EN across settings, such as in hospitals, homes, and communities, or provide standardized nutritional treatment plans because of varying levels of education and experience in EN. The leadership ability of nurses is reflected by their ability to quickly screen patients for malnourishment, initiate and organize IPTs to develop standard nutritional intervention strategies, and quickly implement and dynamically adjust interventions. Nurses can also provide comprehensive nutrition management and organization across various environments and settings to help patients achieve better nutritional status and improve treatment outcomes. Because nurses have the most frequent contact with patients of all clinical team members, they often have a strong understanding of patients’ nutrition, illness, psychology, family, and condition over time. Physicians may have limited contact with patients, making it difficult to detect changes in their nutritional status in a timely manner. For example, some patients may not be able to return to the outpatient department for follow-up after discharge for various reasons. Nurse-led teams can initiate nutrition interventions earlier (e.g., initiation in less than 24 hours), and the duration and intake adherence rate of nurse-led IPT-based nutrition interventions are also higher than standard physician-led methods. This enables patients to receive timelier and more comprehensive EN interventions, which is particularly important for critically ill patients ( Kreymann et al., 2006 ). Multiple studies have shown that nutritional therapy for patients with esophageal cancer during radiation therapy can improve their nutritional status and reduce the occurrence of adverse events ( Liu et al., 2022 ; Wang et al., 2023 ; Zhang et al., 2022 ), which is consistent with findings from the current study. However, standardized methods for EN management, as well as research on the impact of EN management on therapeutic efficacy in esophageal cancer, are lacking in the literature. This study developed a nurse-led, IPT-based nursing intervention model for whole-course EN, providing patients with personalized, standardized, and continuous EN management plans, fully leveraging the leading role of nurses, improving treatment effectiveness (i.e., increasing OS and PFS), and reducing the occurrence of severe adverse events. The efficacy of radiation therapy is closely related to its completion rate. The number of interruptions to radiation therapy is used as one of the evaluation criteria for patient treatment efficacy ( Yang et al., 2018 ; Zhou et al., 2023 ). In the current study, the intervention group significantly lowered the incidence and severity of adverse events, which reduced the number of interruptions to radiation therapy, consistent with those results. The quality of life of patients is reflected in their overall satisfaction with various objective and subjective aspects as measured by questionnaires like the EORTC QLQ-C30, with physical, emotional, cognitive, social, and role-related quality-of-life functional domains. Research has shown that nutritional status is closely related to quality of life in patients with cancer, particularly regarding decreased nutritional status during radiation therapy for gastrointestinal tumors, which may lead to a decline in quality of life ( Kutz et al., 2022 ). However, during the peri–radiation therapy period of treatment for esophageal cancer, there are relatively few reports on how to conduct systematic, standardized, comprehensive nutritional management. Research about the impact of these management measures on the quality of life in these patients is also scarce. This study implemented a guideline-based, systematic, standardized diagnosis and individualized nursing intervention for patients through a nurse-led IPT model. Limitations This study has some limitations. First, considering the small sample size and the participants being recruited from a single research center, the intervention effect of this study should be carefully considered. A larger sample size across multiple centers can support stronger correlations among variables being studied. In addition, a very small proportion of patients received parenteral nutrition support therapy in addition to EN therapy, which may be a confounding bias. Additional research is needed to analyze the influencing variables. Implications for Practice This study implemented nurse-led IPTs to manage EN throughout the entire care process for patients with esophageal cancer receiving radiation therapy, including developing standardized and regulated EN treatment plans for patients, dynamically evaluating and adjusting EN treatments, and extending them to the home or outpatient setting. Nurse-led IPT-based EN interventions can support the pathologic, physiologic, psychological, social, cultural, and spiritual needs of patients. Conclusion For patients with esophageal cancer in the peri–radiation therapy period, implementing a nurse-led EN intervention based on the IPT model may improve the patient’s nutritional status, including reducing malnutrition and weight loss. In addition, this study’s results show that the implementation of a whole-course EN nursing intervention can help to reduce the incidence of severe adverse events from and interruptions to radiation therapy (i.e., facilitating the complete implementation of the patient’s diagnosis and treatment plan), improving OS and PFS time, and enhancing the patient’s quality of life overall and across various functional domains. This may also provide a better EN management plan in the peri–chemotherapy and radiation therapy period for patients with other types of cancer (e.g., head and neck tumors, digestive tract tumors) who are prone to malnutrition. IMPLICATIONS FOR PRACTICE. ■ Conduct prealbumin, albumin, and hemoglobin tests at least every two weeks to detect malnutrition early for enteral nutrition interventions for patients receiving radiation therapy for esophageal cancer. ■ Perform tests of physical, role, cognitive, and social function in patients for information to enhance overall quality of life, and remind family members to pay attention to changes in patients’ quality of life. ■ Regularly educate patients receiving radiation therapy and their families about nutrition and promptly reply to patient concerns during the process of enteral nutrition at home. Funding Statement This work was supported by the Suzhou Radiotherapy Clinical Medical Center (No. SZLCYXZX202103), the 2020 Suzhou Science and Technology Development Plan (No. SYSD2020117), the Suzhou Science and Technology Plan (Medical and Health Technology Innovation) (No. SKJY2021080), and the National Natural Science Foundation Pre-Research Project of the Second Affiliated Hospital of Soochow University (No. SDFEYGJ2003). Footnotes The authors gratefully acknowledge Zaixiang Tang, PhD, for providing statistics guidance for this article. The authors take full responsibility for this content. 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Effect of the hospital-community-family (HCF) nutritional management on patients with esophageal and head and neck cancers undergoing radiotherapy: A randomized control trial.

Translational Cancer Research. 2023;12(2):375–386. doi: 10.21037/tcr-22-2785. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] Articles from Clinical Journal of Oncology Nursing are provided here courtesy of Oncology Nursing Society ACTIONS View on publisher site PDF (288.7 KB) Cite Collections Permalink RESOURCES Similar articles Cited by other articles Links to NCBI Databases Follow NCBI NCBI on X (formerly known as Twitter) NCBI on Facebook NCBI on LinkedIn NCBI on GitHub NCBI RSS feed Connect with NLM NLM on X (formerly known as Twitter) NLM on Facebook NLM on YouTube National Library of Medicine 8600 Rockville Pike Bethesda, MD 20894 Web Policies FOIA HHS Vulnerability Disclosure Help Accessibility Careers NLM NIH HHS USA.gov Back to Top

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