High-protein oral nutritional supplement use in patients with cancer reduces complications and length of hospital stay: a systematic review and meta-analysis
Abstract
Introduction: Oral nutritional supplements (ONS) have been reported to improve nutritional status, quality of life and clinical outcomes in many patient groups. This systematic review investigated the effects of high-protein ONS (HPONS), ≥20% energy from protein, on clinical outcomes in cancer patients.
Methods: A systematic review (searches to January 2025) identified 32 publications reporting results from 29 randomised controlled trials (RCTs) (n = 2,279) of HPONS (mean daily intake 580 kcal, 34 g protein, ranging from 5 to 365 days) alongside dietary intake in patients with gastrointestinal (GI) (14RCTs), lung (4RCTs), head and neck (4RCTs), liver (2RCTs), breast (1RCT), and mixed (4RCTs) cancers across hospital and community undergoing surgery, chemotherapy, and/or radiotherapy. Studies reporting relevant outcomes (complications, length of hospital stay (LOS), hospital readmissions, and mortality) were pooled into a meta-analysis (Comprehensive Meta-Analysis software v4).
Results: Meta-analysis showed a significant overall reduction (101 fewer per 1,000 patients) in complications (15RCTs, n = 1,230), including infectious, non-infectious and post-operative complications, and radiotherapy-related toxicities in patients using HPONS undergoing surgery and/or chemo/chemo-radiotherapy (OR: 0.62, 95% CI: 0.48-0.81; p = 0.0005; I 2 = 0%) vs. control. The number needed to treat for preventing one additional complication with HPONS was 12 (95% CI: 9-29). A sub-group of studies…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 2,279 participants or records.
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