Influence of chemoradiotherapy on nutritional status in locally advanced rectal cancer: Prospective multicenter study.

Abstract

OBJECTIVE:

The aim of this study was to investigate the influence of chemoradiotherapy (CRT) on nutritional status and the association between changes in nutritional status and clinical outcomes (treatment completion, adverse events, perioperative complications, and relapse-free survival [RFS]) in patients with locally advanced rectal cancer (LARC).

METHODS:

In this multicenter, phase II study, 41 patients with LARC underwent CRT for 5 wk, followed by a 6- to 8-wk interval before surgery. Body weight, body mass index (BMI), lean body mass, serum albumin, and prealbumin levels were measured before (pre-), during, and after CRT, and before surgery. Changes in these data and scores on the Malnutrition Universal Screening Tool (MUST) were calculated based on pre-CRT status.

RESULTS:

Twelve patients (29.3%) experienced body weight loss (BWL) ≥5% (defined as malnutrition) after CRT (P < 0.001) and before surgery (P = 0.035). Significant changes were seen in serum albumin levels and BMI during and after CRT (P < 0.001), and in MUST scores after CRT (P = 0.003) and before surgery (P = 0.035). Treatment completion was significantly associated with BWL (P = 0.028), MUST score (P = 0.013), and decreased serum albumin level (P = 0.001) after CRT. Regarding adverse events, MUST score before surgery (P = 0.009) and serum albumin level after CRT (P = 0.002) were significantly associated with diarrhea severity. Serum albumin level during CRT was associated with the onset of neutropenia (P = 0.005). No association was found between BWL and RFS.

CONCLUSIONS:

These findings suggest that malnutrition and changes in nutritional status are not only commonly observed after CRT, but also associated with treatment completion and adverse events.

• Authors: Tomoki Yamano, Naohiro Tomita, Takeo Sato, Kazushige Hayakawa, Norihiko Kamikonya, Shuichiro Matoba, Akiyoshi Uki, Hideo Baba, Natsuo Oya, Hirotoshi Hasegawa, Naoyuki Shigematsu, Masahiro Hiraoka, Mitsuo Shimada, Masafumi Noda, Yoshiharu Sakai, Hirohiko Sato, Makoto Saegusa, Masahiro Takeuchi, Masahiko Oguchi, Masatoshi Oya, Masahiko Watanabe
• Journal: Nutrition (Burbank, Los Angeles County, Calif.) (Nutrition) Vol. 77 Pg. 110807 (09 2020) ISSN: 1873-1244 [Electronic] United States
• PMID: 32402940 (Publication Type: Clinical Trial, Phase II, Journal Article, Multicenter Study)
• Copyright: Copyright © 2020 Elsevier Inc. All rights reserved.

Topics

• Chemoradiotherapy (adverse effects)
• Humans
• Malnutrition
• Neoadjuvant Therapy
• Nutritional Status
• Prospective Studies
• Rectal Neoplasms (therapy)
• Treatment Outcome