Influence of chemoradiotherapy on nutritional status, functional capacity, quality of life and toxicity of treatment for patients with cervical cancer

Aredes, Mariah Azevedo; Garcez, Marcelly R.; Chaves, Gabriela Villaça

doi:10.1111/1747-0080.12414

Cited by 33 publications

(32 citation statements)

References 40 publications

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“…Next, there was a significant difference in patients' HGS between subgroups based on KPS scores. Patients with a poorer PS had significantly lower HGS measurements compared to patients with a higher PS, a trend noted in other studies as well [55,[60][61][62]. PS is an important indicator of a patient's ability to be functional and perform activities of daily living.…”

Section: Discussionmentioning

confidence: 54%

Nutritional Status and Quality of Life in Hospitalised Cancer Patients Who Develop Intestinal Failure and Require Parenteral Nutrition: An Observational Study

et al. 2020

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(1) Background: Malnutrition in cancer patients impacts quality of life (QoL) and performance status (PS). When oral/enteral nutrition is not possible and patients develop intestinal failure, parenteral nutrition (PN) is indicated. Our aim was to assess nutritional status, QoL, and PS in hospitalised cancer patients recently initiated on PN for intestinal failure. (2) Methods: The design was a cross-sectional observational study. The following information was captured: demographic, anthropometric, biochemical and medical information, as well as nutritional screening tool (NST), patient-generated subjective global assessment (PG-SGA), functional assessment of cancer therapy-general (FACT-G), and Karnofsky PS (KPS) data. (3) Results: Among 85 PN referrals, 30 oncology patients (56.2 years, 56.7% male) were identified. Mean weight (60.3 ± 16.6 kg) corresponded to normal body mass index values (21.0 ± 5.1 kg/m2). However, weight loss was significant in patients with gastrointestinal tumours (p < 0.01). A high malnutrition risk was present in 53.3–56.7% of patients, depending on the screening tool. Patients had impaired QoL (FACT-G: 26.6 ± 9.8) but PS indicated above average capability with independent daily activities (KPS: 60 ± 10). (4) Conclusions: Future research should assess the impact of impaired NS and QoL on clinical outcomes such as survival, with a view to encompassing nutritional and QoL assessment in the management pathway of this patient group.

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Section: Discussionmentioning

confidence: 54%

Nutritional Status and Quality of Life in Hospitalised Cancer Patients Who Develop Intestinal Failure and Require Parenteral Nutrition: An Observational Study

et al. 2020

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“…In Fig. 3b, we can observe that after treatment the patient population moves to the bottom left, the median for all indices are significantly reduced, BMI is 25 (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34), SMI is 37.9 (18.3-52.6), SATI 72.2 (6.6-167.9) and VATI 32.3 (3.8-69.9). After treatment, 58.3% patients develop sarcopenia; some of these patients who develop sarcopenia are obese according to a BMI ≥30 and also present high visceral and subcutaneous adiposity.…”

Section: Decline Of the Nutritional Status Of Locally Advanced Cervicmentioning

confidence: 89%

Deterioration of nutritional status of patients with locally advanced cervical cancer during treatment with concomitant chemoradiotherapy

Sánchez

Castro-Eguiluz

Luvian-Morales

et al. 2019

J Human Nutrition Diet

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Background In Mexico, 80% women with cervical cancer are diagnosed at locally advanced stages and are treated with concomitant chemoradiotherapy. The treatment modality and catabolic state confer a nutritional risk. The present study aimed to thoroughly evaluate the nutritional status and change in body composition of locally advanced cervical cancer (LACC) patients throughout treatment. Methods An observational prospective study, carried out at the Mexican National Cancer Institute, included 55 LACC patients. Nutritional status was evaluated before, during and after treatment, using anthropometric, dietary and biochemical measurements. Body composition was analysed using computed tomography images obtained at the time of diagnosis and approximately 4 months after treatment completion. Clinical outcomes were associated with changes in body composition. Results At the time of diagnosis, no patients were clinically malnourished, although 33.3% presented sarcopenia and most were overweight; by the end of treatment, 69% became clinically malnourished and 58% were sarcopenic. Average weight loss was 7.4 kg (P = 0.001). Adequacy of energy intake was reduced to 54%, obtained predominantly from carbohydrates. By the week 9, 62.8% patients became anemic and 34.5% had low albumin levels. Body composition analysis revealed that patients lost both, muscle and adipose tissues, although 27% patients were muscle depleted by the end of treatment. Patients who lost ≥10% skeletal muscle presented a higher tumour recurrence (hazard ratio = 2.957, P = 0.006) and a tendency towards diminished overall survival (hazard ratio = 2.572, not significant). Conclusions The nutritional status of cervical cancer patients deteriorates during treatment with concomitant chemoradiotherapy and, most importantly, muscle loss impacts the clinical outcome of patients.

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“…Actually, the proportion of patients received the surgery treatments were corresponding to cases' 3-year CSS rates variation in different states. With postoperative adjuvant therapy 30 , laparoscopic radical surgery and robot-assisted surgery widely applying for the cervical cancer surgery treatment [31][32][33] , the higher 3-CSS rates for the cases with well or moderate differentiation tumor demonstrated in these economic advanced states. In some areas, African Americans were the majority of the patients who were less likely to receive surgical treatment 34 , and showed worse survival in the long trend.…”

Section: Discussionmentioning

confidence: 99%

“…Because of the higher level of economic condition and more complete healthcare environment construction in California, Connecticut and Washington, patients there would have more strategies for conservative treatment, comparing with patients in Michigan and New Mexico. Although patients with poorly differentiation tumor or in late stages only took up a small proportion in all registered cases, most of these patients generally lost chances for surgery, so chemoradiotherapy 32,34,35 became a vital treatment method for them, which draw more attention by the government in U.S. Unfortunately, in many low and middle-income states, radiation therapy capacity is severely limited 36 , leading to the worse prognosis in Michigan and New Mexico.…”

Section: Discussionmentioning

confidence: 99%

Area-specific economic status should be regarded as a vital factor affecting the occurrence, development and outcome of cervical cancer

et al. 2020

Sci Rep

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For patients with cervical cancer, despite the incidence and mortality rates have been declining in recent years, due to its huge population base, cervical cancer has always been a serious public health problem. Our research placed emphasis on the indices greatly associated with overall area-specific social economic status, making up for the defects of traditional research which only pay attention to the situation of some specific disease or patients' individual social status. A total of 39160 women identified cervical cancer were concluded in our study from the Surveillance, Epidemiology, and End Results (SEER) 18 Program data between 1980 and 2014. With improving the area-specific social economic factors in recent years, the occurrence and prognosis of cervical cancer showed different variation patterns respectively. Some states like California and Georgia for their better economic status and more healthcare investment by local medical institution, population there showed a lower prevalence, incidence, more timely diagnosis, effective treatment, and better prognosis. According to our study, we aimed to give a scientific interpretation on how the area-specific social economic factors affect the disease situation at the macro level and help local medical institution make advisable decisions for controlling cervical cancer.Cervical cancer is the fourth most frequent diagnosed cancer type 1 and the third leading cause of cancer deaths among females in the world. In United States, it was also regarded as an important public health problem, for nearly 250,000 women currently live with the cervical cancer 2 , 12,820 new cases' occurrence and 4,210 patients' deaths annually 3 .With the progress in research targeting to cervical cancer, infection of the Human Papilloma virus (HPV) was confirmed as a vital etiologic risk factor of cervical cancer. Due to the promotion of first screening, the incidence and the mortality rates decreased gradually though early intervention and reduction of the risk factors 4 . As a result, cervical cancer became a preventable disease in general population.In recent years, more and more women got benefits from medical development under the support by local economic institution, for spreading HPV vaccine since 2006 4 and applying many advanced treatment gradually. However, in some underdeveloped areas, most women still suffered undiagnosed and had limited access to proper treatment or prevention in their daily life 5-8 . These differences might derive from many aspects. According to previous studies, variation of patients' incidence rates and outcome have been greatly associated with ages, tumor histology, tumor differentiation 7,9,10 , and individual socioeconomic status, including race/ethnicity and insurance status [11][12][13] . However, the overall social economic factors have been ignored, which may be greatly associated

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Influence of chemoradiotherapy on nutritional status, functional capacity, quality of life and toxicity of treatment for patients with cervical cancer

Abstract: Chemoradiotherapy treatment in patients with cervical cancer had changed negative nutritional parameters, function capacity and QoL, and poor nutritional status at baseline was associated with chemotherapy interruption.

Cited by 33 publications

References 40 publications

Nutritional Status and Quality of Life in Hospitalised Cancer Patients Who Develop Intestinal Failure and Require Parenteral Nutrition: An Observational Study

Nutritional Status and Quality of Life in Hospitalised Cancer Patients Who Develop Intestinal Failure and Require Parenteral Nutrition: An Observational Study

Deterioration of nutritional status of patients with locally advanced cervical cancer during treatment with concomitant chemoradiotherapy

Area-specific economic status should be regarded as a vital factor affecting the occurrence, development and outcome of cervical cancer

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