Digestive toxicity in cancer treatments. Bibliographic review. Influence on nutritional status

Domínguez, Teresa Alonso; Andrés, Miguel Civera; Crespo, José Antonio Santiago; Malpartida, Khaterine García; Romero, Francisco Botella

doi:10.1016/j.endien.2023.02.004

Cited by 2 publications

(4 citation statements)

References 20 publications

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“…Regarding other works in the field, there is little information about the best nutritional support for patients with cancer [ 9 , 19 , 20 ]. Antineoplastic agents are known to be associated with gastrointestinal complications that lead to physical and nutritional repercussions, which can decrease well-being and result in death due to malnutrition [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…This is because both the development of the disease and antineoplastic treatment can lead to caloric-protein malnutrition, leading to a high prevalence of adverse effects in daily clinical practice [ 1 ]. New treatments and conventional chemotherapy lead to toxicity in the gastrointestinal tract, which has a direct impact on the patient's well-being and survival [ 2 - 9 ]. Medical management is often insufficient to carry out a comprehensive assessment of the patient’s physical and nutritional well-being.…”

Section: Introductionmentioning

confidence: 99%

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Development and Implementation of an eHealth Oncohematonootric Program: Descriptive, Observational, Prospective Cohort Pilot Study

Sánchez-Quiñones,

Antón-Maldonado,

Ibarra Vega

et al. 2024

JMIR Form Res

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Background In oncohematology, both the development of the disease and the side effects of antineoplastic treatment often take a toll on patients’ physical and nutritional well-being. In this era of digital transformation, we launched a pioneering project for oncohematologic patients to promote adherence to a healthy lifestyle and improve their physical and nutritional well-being. We aim to achieve this goal by involving doctors and nutritionists through the Nootric app. Objective This study aims to assess the impact of the use of eHealth tools to facilitate nutrition and well-being in oncohematologic patients. We also aim to determine the usefulness of physical-nutritional management in improving tolerance to chemotherapy treatments within routine clinical practice. Methods We designed a descriptive, observational, longitudinal, prospective cohort pilot study that included a total of 22 patients from March to May 2022 in the Vinalopó University Hospital. The inclusion criteria were adults over 18 years of age diagnosed with oncohematological pathology in active chemotherapy treatment. An action plan was created to generate alerts between the doctor and the nutritionist. In the beginning, the patients were trained to use the app and received education highlighting the importance of nutrition and physical exercise. Sociodemographic, clinical-biological-analytical (eg, malnutrition index), health care impact, usability, and patient adherence data were collected. Tolerance to chemotherapy treatment and its health care impact were evaluated. Results We included 22 patients, 11 (50%) female and 11 (50%) male, ranging between 42 and 84 years of age. Among them, 13 (59%) were adherents to the program. The most frequent diseases were lymphoproliferative syndromes (13/22, 59%) and multiple myeloma (4/22, 18%). Moreover, 15 (68%) out of 22 patients received immunochemotherapy, while 7 (32%) out of 22 patients received biological treatment. No worsening of clinical-biological parameters was observed. Excluding dropouts and abandonments (n=9/22, 41%), the adherence rate was 81%, established by calculating the arithmetic mean of the adherence rates of 13 patients. No admission was observed due to gastrointestinal toxicity or discontinuation of treatment related to alterations in physical and nutritional well-being. In addition, only 5.5% of unscheduled consultations were increased due to incidents in well-being, mostly telematic (n=6/103 consultation are unscheduled). Additionally, 92% of patients reported an improvement in their nutritional habits (n=12/13), and up to 45% required adjustment of medical supportive treatment (n=5/11). There were no cases of grade 3 or greater gastrointestinal toxicity. All of this reflects improved tolerance to treatments. Patients reported a satisfaction score of 4.3 out of 5, while professionals rated their satisfaction at 4.8 out of 5. Conclusions We demonstrated the usefulness of integrating new technologies through a multidisciplinary approach. The Nootric app facilitated collaboration among the medical team, nutritionists, and patients. It enabled us to detect health issues related to physical-nutritional well-being, anticipate major complications, and mitigate potentially avoidable risks. Consequently, there was a decrease in unscheduled visits and admissions related to this condition.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Development and Implementation of an eHealth Oncohematonootric Program: Descriptive, Observational, Prospective Cohort Pilot Study

Sánchez-Quiñones,

Antón-Maldonado,

Ibarra Vega

et al. 2024

JMIR Form Res

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“…8 result in impaired oral intake in the absence of aggressive symptom control and targeted nutrition therapies. 23 It is critical to maintain nutrition intake during neoadjuvant therapy because the ultimate goal is to successfully undergo surgical resection, and malnutrition may present a barrier to surgery. Unfortunately, up to 40% of individuals who present with borderline resectable PDAC are not ultimately candidates for resection.…”

Section: Cancer Staging and Treatmentsmentioning

confidence: 99%

“…These therapies involve combination chemotherapy regimens such as fluorouracil, irinotecan, oxaliplatin, and leucovorin (FOLFIRINOX) or gemcitabine with nab‐paclitaxel; treatment may also include external beam radiation therapy targeting the primary tumor. These regimens have high risks of gastrointestinal toxicities, including nausea, vomiting, and diarrhea, which often result in impaired oral intake in the absence of aggressive symptom control and targeted nutrition therapies 23 . It is critical to maintain nutrition intake during neoadjuvant therapy because the ultimate goal is to successfully undergo surgical resection, and malnutrition may present a barrier to surgery.…”

Section: Clinical Features Of Pdacmentioning

confidence: 99%

Fat malabsorption in pancreatic cancer: Pathophysiology and management

Murray,

Ramsey,

Hart

et al. 2024

Nut in Clin Prac

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Exocrine pancreatic insufficiency (EPI) is common in pancreatic ductal adenocarcinoma (PDAC) and may lead to significant nutrition compromise. In the setting of cancer cachexia and gastrointestinal toxicities of cancer treatments, untreated (or undertreated) EPI exacerbates weight loss, sarcopenia, micronutrient deficiencies, and malnutrition. Together, these complications contribute to poor tolerance of oncologic therapies and negatively impact survival. Treatment of EPI in PDAC involves the addition of pancreatic enzyme replacement therapy, with titration to improve gastrointestinal symptoms. Medical nutrition therapies may also be applicable and may include fat‐soluble vitamin replacement, medium‐chain triglycerides, and, in some cases, enteral nutrition. Optimizing nutrition status is an important adjunct treatment approach to improve quality of life and may also improve overall survival.

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Digestive toxicity in cancer treatments. Bibliographic review. Influence on nutritional status

Cited by 2 publications

References 20 publications

Development and Implementation of an eHealth Oncohematonootric Program: Descriptive, Observational, Prospective Cohort Pilot Study

Development and Implementation of an eHealth Oncohematonootric Program: Descriptive, Observational, Prospective Cohort Pilot Study

Fat malabsorption in pancreatic cancer: Pathophysiology and management

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