Effects of whole cycle nutrition management based on “Hospital to Home (H2H)” model on nutritional status and immune function of patients with gastrointestinal tumor chemotherapy

Aim To evaluate effects of whole-cycle nutrition management based on “Hospital to Home (H2H)” model on nutritional status and immune function in gastric and colorectal cancer patients receiving chemotherapy. Methods In this randomized controlled trial, 100 gastric or colorectal cancer patients with malnutrition risk (PG-SGA ≥ 2) were randomly assigned to routine nursing (control, n = 50) or H2H nutrition management plus routine nursing (study, n = 50). Primary outcomes were PG-SGA score and serum albumin. Secondary outcomes included immune function (CD4+, CD8 + counts, CD4+/CD8 + ratio), hematological parameters, cancer-related fatigue (PFS), self-care ability (ESCA), quality of life (GQOLI-74), adverse reactions (CTCAE 5.0), and nursing satisfaction. Linear mixed-effects models with FDR correction were used for repeated measures. Results The study group showed significantly greater improvements in PG-SGA score (mean difference at cycle 6: −1.4, 95% CI: −1.9 to −0.9, p < 0.001) and serum albumin (+2.7 g/L, 95% CI: 1.5 to 3.9, p < 0.001). CD4 + counts (+95 cells/μL, p < 0.001) and CD4+/CD8 + ratio (+0.35, p < 0.001) were significantly higher in the study group. Cancer-related fatigue (PFS) decreased, while self-care ability (ESCA) and quality of life (GQOLI-74) improved more in the study group (all q < 0.05). Adverse reactions were lower (4.0% vs. 20.0%, p = 0.01) and nursing satisfaction higher (96.0% vs. 80.0%, p = 0.01) in the study group. Conclusion H2H whole-cycle nutrition management improves nutritional status, immune function, fatigue, self-care ability, quality of life, and satisfaction while reducing adverse reactions in gastric and colorectal cancer patients receiving chemotherapy. Larger multicenter studies with long-term follow-up are needed to confirm these findings and assess survival outcomes.