Impact of chemotherapy on symptom profile, oxidant-antioxidant balance and nutritional status in non-small cell Lung Cancer

Abstract

Background:Lung cancer is associated with an oxidant-antioxidant imbalance that is implicated in tumor progression. However, the association of this imbalance on disease burden and treatment response is unclear. The effect of chemotherapy on oxidative stress, antioxidant status, and nutritional profile in patients with advanced nonsmall cell lung cancer (NSCLC) was prospectively evaluated.Subjects and Methods:Patients with confirmed cytological/histological diagnosis of NSCLC were recruited. Performance status was determined using the Eastern Cooperative Oncology Group grading and the Karnofsky Performance Scale. Skin fold anthropometry was done for nutritional assessment. All patients received chemotherapy with intravenous carboplatin and paclitaxel at three-weekly intervals. Response was assessed after four cycles by repeat imaging. Plasma levels of total antioxidant status (TAS), malondialdehyde (MDA), and glutathione peroxidase (GPx) levels were estimated using commercially available kits, and the change was correlated with clinical outcome, response to chemotherapy, performance status, and nutritional profile.Results:Thirty-five cases were studied (92% males), with a mean (SD) age of 56.2 (9.3) years. Following treatment, majority of patients demonstrated stable disease (n = 15 [42%]), followed by partial response (29%), progressive disease (22%), and complete remission (6%). Significant improvement occurred in respiratory symptoms. Body fat declined while subscapular skinfold thickness and 6-min walk distance increased. Spirometric values and performance status remained unchanged. GPx levels declined significantly while no notable change was observed in MDA and TAS levels.Conclusions:Chemotherapy for NSCLC improves symptoms, nutritional status, and exercise capacity but worsens the antioxidant status.

A pilot study to assess oxidative and inflammatory markers as early indicator for response to chemotherapy in non‐small cell lung cancer

“…Levels of MDA variably increased or decreased after first‐cycle of chemotherapy but the overall post‐treatment change in each group was not statistically significant. Mohan et al did not observed any significant change in the levels of MDA at the end of four cycles. In contrast, Gupta et al observed significant increase after three cycles of cisplatin + etoposide which was lesser for responders as compared to non‐responders.…”

“…[6][7][8][9] Increase in oxidative stress following chemotherapy is reported in one study while no change has been reported in another. 3,10 In contrast, Wakabayashi et al 11 observed significant change in oxidative stress which correlated with response to chemotherapy. Change in inflammatory markers with therapy has also been inconsistently related with response to treatment.…”

Sera total oxidant/antioxidant status in lung cancer patients

“…Taherkhani et al [35] have shown that a concurrent significant increase in malondialdehyde levels and a significant decrease in TAS levels were observed after 3 cycles of adriamycin and cytoxan chemotherapy in patients with breast cancer. However, Mohan et al [36] and Krawczyk et al [37] have observed no oxidative stress parameters change was observed after chemotherapy in nonsmall cell lung cancer (NSCLC). And the oxidative stress parameters have the different changes after radiotherapy in different cancer.…”

Effects of Docetaxel Combined with Icotinib on Serum Tumor Markers and Quality of Life of Patients with Advanced Non-Small Cell Lung Cancer

“…Patients with advanced NSCLC diagnosed by cytology, histology and iconography ( 10 ). Patients with complete clinical data.…”