The relevance of weight loss for survival and quality of life in patients with advanced gastrointestinal cancer treated with palliative chemotherapy.
BACKGROUND
Chemotherapy is frequently used for palliation in patients with advanced gastrointestinal (GI) cancer and improvements in quality of life (QoL) and survival are documented. Several pre-treatment factors, particularly poor performance status, influence the outcomes. The relative importance of nutrition-associated factors is less well known.


METHODS
Data from 152 patients treated within four randomised studies were analysed to explore the relations between weight loss, nutrition-associated parameters, performance status, response to chemotherapy, global QoL and survival.


RESULTS
Patients with weight loss, poor performance, higher frequency of nutritional problems and low haemoglobin levels had a lower probability of responding to treatment. Global QoL was decreased in patients having weight loss as well as problems with pain or fatigue. Diagnosis had the strongest association to survival. In a multivariate analysis poor performance and weight loss were also independently related to survival.


CONCLUSIONS
Weight loss and several nutrition-associated problems were associated with lower QoL, less likelihood to respond to chemotherapy and poor survival.
Persson
Christina
C
Department of Oncology, Radiology and Clinical Immunology, University Hospital, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden. christina.persson@pubcare.uu.se
Glimelius
Bengt
B
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy* / Q000503:physiopathology*; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D009752:Nutritional Status / Q000502:physiology; D010166:Palliative Care / Q000379:methods*; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D015996:Survival Rate; D015431:Weight Loss / Q000502:physiology*
D002955:Leucovorin; D005472:Fluorouracil