ESPEN Guidelines on Enteral Nutrition: Non-surgical oncology

J. Arends, G. Bodoky, F. Bozzetti, K. Fearon, M. Muscaritoli, G. Selga, M. A.E. van Bokhorst-de van der Schueren, M. von Meyenfeldt, G. Zürcher, R. Fietkau, E. Aulbert, B. Frick, M. Holm, M. Kneba, H. J. Mestrom, A. Zander

Research output: Contribution to journalArticlepeer-review

153 Citations (Scopus)


Enteral nutrition (EN) by means of oral nutritional supplements (ONS) and tube feeding (TF) offers the possibility of increasing or ensuring nutrient intake in cases where normal food intake is inadequate. These guidelines are intended to give evidence-based recommendations for the use of ONS and TF in cancer patients. They were developed by an interdisciplinary expert group in accordance with officially accepted standards, are based on all relevant publications since 1985 and were discussed and accepted in a consensus conference. Undernutrition and cachexia occur frequently in cancer patients and are indicators of poor prognosis. EN should be started if undernutrition already exists or if food intake is markedly reduced for more than 7-10 days. Standard formulae are recommended for EN. Nutritional needs generally are comparable to non-cancer subjects. In cachectic patients metabolic modulators such as progestins, steroids and possibly eicosapentaenoic acid may help to improve nutritional status. EN is indicated preoperatively for 5-7 days in cancer patients undergoing major abdominal surgery. During radiotherapy of head/neck and gastrointestinal regions dietary counselling and ONS prevent weight loss and interruption of radiotherapy. Routine EN is not indicated during (high-dose) chemotherapy. The full version of this article is available at

Original languageEnglish
Pages (from-to)245-259
Number of pages15
JournalClinical Nutrition
Issue number2
Publication statusPublished - Apr 2006
Externally publishedYes


  • Cachexia
  • Chemotherapy
  • Clinical practice
  • Enteral nutrition
  • Evidence-based
  • Guideline
  • Hematopoietic stem cell transplantation
  • Malnutrition
  • Oncology
  • Oral nutritional supplements
  • Radiotherapy
  • Tube feeding
  • Undernutrition
  • Wasting

Field of Science*

  • 3.2 Clinical medicine

Publication Type*

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database


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