The nutritional status of patients submitted to hematopoietic stem cell transplant is considered an independent risk factor, which may influence on quality of life and tolerance to the proposed treatment. The impairment of nutritional status during hematopoietic stem cell transplant occurs mainly due to the adverse effects resulting from conditioning to which the patient is subjected. Therefore, adequate nutritional evaluation and follow-up during hematopoietic stem cell transplant are essential. To emphasize the importance of nutritional status and body composition during treatment, as well as the main characteristics related to the nutritional assessment of the patient, the Brazilian Consensus on Nutrition in Hematopoietic Stem Cell Transplant: Adults was prepared, aiming to standardize and update Nutritional Therapy in this area. Dietitians, nutrition physicians and hematologists from 15 Brazilian centers thar are references in hematopoietic stem cell transplant took part.

Objective: To determine whether preoperative anthropometric and computed tomography (CT) measurements of body composition can predict postoperative morbidity and mortality in patients with gastric or esophageal cancer. Materials and Methods: This was a retrospective study in which we reviewed the medical records and abdominal CT scans of patients with gastric or esophageal cancer who underwent surgery in 2015 at a cancer center. CT scans performed during routine preoperative evaluation were retrospectively assessed to measure the area of lean body mass at the level of the third lumbar vertebra, as well as the area of visceral and subcutaneous fat. Results: Seventy patients were included in the study. The mean age was 59.9 years (range, 33-82 years), and 47 patients (67.1%) were men. The mean postoperative follow-up period was 14.9 months. Neither postoperative morbidity nor postoperative mortality correlated significantly with gender, age, the type of primary tumor, the presence of comorbidities, smoking status, body mass index, nutritional status, or visceral fat area. The survival rate was higher for patients with normal lean body mass than for those with low lean body mass (hazard ratio = 0.116; 95% confidence interval: 0.015-0.906; p = 0.040). Conclusion: Our data suggest that lean body mass can be a relevant prognostic factor in patients with gastric or esophageal cancer, and that CT measurements should be included in the routine preoperative evaluation, because it may provide information that aids nutritional and clinical care for these patients.

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Introduction:Malnutrition affects an average of 20-80% of cancer patients, leading to an impaired healing process, increased infection rates and hospital costs, and negative impacts on clinical results. Oral nutritional supplements (ONS) help to increase the patients caloric and protein supplies, promoting recovery of nutritional status. In order to have good adherence to the ONS, it is necessary that the multidisciplinary team assigned is aligned with regard to the information transferred to the patient. Objectives: This study aimed to assess the technical knowledge about oral nutritional therapy (ONT) among physicians and the nursing staff at a private institution. Materials and Methods: This was a descriptive cross-sectional study. The physicians and residents as well as the nursing staff who work in clinical patient care were invited to answer a semi-structured questionnaire to assess their technical knowledge regarding ONT. Results: This study evaluated 105 professionals. Most physicians and nursing staff stated that ONS is a food supplement. Although they reported not having had technical training on the subject, most of them felt capable of prescribing and providing guidance participants neglected symptoms and conditions relevant to the nutritional status of the patient, such ascites, enteral nutritional therapy and home parenteral nutrition, concomitant chemotherapy/radiotherapy, and emesis. Conclusion: Information about ONS among medical and nursing professionals varies greatly. Interdisciplinary technical training is essential for the success of ONT as a tool for preventing and combating malnutrition.

Introduction: Nutritional status is one of the independent factors that most influence postoperative outcomes in elective colorectal surgeries. Adequate muscle mass and strength contribute to the reduction of complications and can be evaluated in the preoperative period as prognostic markers. Objective: To compare lean mass (LM) with muscle strength (MS) in patients with colorectal cancer in the preoperative period. Methods: A retrospective study carried out with 87 patients from the nutrition clinic of the A. C. Camargo Cancer Center Hospital. Dynamometry was used to assess MS and bioelectrical impedance analysis (BIA) was used to assess LM. Results: Most of the results were male (51.7%) with a mean age of 60.7 years. The most prevalent Body Mass Index (BMI) classification was normal weight (50.6%) and the sample showed a higher prevalence of resistant LM and MS (70.1% and 67.8%, respectively). Only 9.2% of the sample presented both MS and LM inadequate. LM was significantly associated with age (p=0.011), BMI (p<0.001), phase angle (PA) (p=0.016) and oncological diagnosis (p=0.042). MS was significantly associated only with age (p<0.001) and PA (p=0.036). LM showed no significant association with MS (p=1.00). Conclusion: This study did not notice an association between lean mass and muscle strength in patients with colorectal cancer. More prospective nutritional therapy is needed to understand this relationship, although both measures can be directed to clinical practice for the most appropriate therapy.

Objective: To correlate body composition measures, based on computed tomography (CT) analysis of muscle mass and adipose tissue, with disease-free survival in breast cancer patients. Materials and Methods: This single-center retrospective study included 262 female patients with nonmetastatic breast cancer. Body composition was assessed on a pretreatment CT scan (at the L3 level). The analysis included quantification of the areas of subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), and skeletal muscle mass, as well as of the mean skeletal muscle density. The VAT/SAT ratio, skeletal mass index (SMI), and skeletal muscle gauge (SMG) were calculated. Results: Of the 262 patients evaluated, 175 (66.8%) were classified as overweight or obese on the basis of their body mass index. We observed low SMI in 35 patients (13.4%) and elevated VAT in 123 (46.9%). Disease-free survival was significantly shorter in the patients who underwent neoadjuvant chemotherapy (p = 0.044), in those with a low SMI (p = 0.006), in those with low SMG (p = 0.013), and in those with a low VAT/SAT ratio (p = 0.050). In a multivariate analysis, only SMG, the VAT/SAT ratio, and having undergone neoadjuvant chemotherapy retained their statistical significance. Conclusion: Our results confirm that low SMG and the VAT/SAT ratio can be used as imaging biomarkers to assess prognosis in patients with nonmetastatic breast cancer.

Objetivo: Avaliar o estado nutricional de pacientes em quimioterapia. Material e métodos: 1222 pacientes foram avaliados através da avaliação subjetiva global produzida pelo paciente (ASG-PPP) no primeiro dia de quimioterapia. Verificaram-se os tipos de tumores e estadiamento do câncer e os sintomas apresentados pelos pacientes no inicio do tratamento. Resultados: 13,8% da amostra encontrou-se em desnutrição e destes os tipos de tumores mais prevalentes foram pele não melanoma, tumores gastrintestinais e pulmão. 40,8% dos pacientes estavam em sobrepeso e obesidade e o câncer de mama foi o mais prevalente neste grupo. Os sintomas mais relatados no inicio do tratamento foram inapetência (13%) e empachamento (10,6%). Conclusão: o estudo ressalta a importância de realizar um método de triagem nutricional para avaliar pacientes oncológicos em risco nutricional durante o a quimioterapia.Palavras-chave: câncer, quimioterapia, avaliação nutricional.

Background: Breast cancer is the most common cancer among women worldwide. This case report aimed to evaluate the effect of specialized oral nutritional supplements (ONS) in the prevention and treatment of radiodermatitis in patients undergoing radiotherapy (RT) for breast cancer. Methods: Case report of three patients during radiotherapy treatment, one using specialized supplementation with a preventive objective and another to treat radiodermatitis, the third patient did not use any supplement, being the control. Results: Patients who used ONS showed beneficial results regarding the appearance of radiodermatitis and evolution of its degree when compared to the control patient. Patient 1 had radiodermatitis only at the end of RT with grade I toxicity. Patient 2 had radiodermatitis in the middle of treatment, where ONS started, with grade I toxicity and the lesion did not progress until the end of treatment. On the other hand, patient 3 had grade I radiodermatitis in the 10th session, evolving to grade II in the 23rd session. Conclusions: It was concluded that the use of specialized ONS helps in the healing process of radiodermatitis in patients undergoing RT in the breast region, in addition to maintaining/improving body composition.