Long-term nutritional and digestive consequences of pelvic radiation.
OBJECTIVE
To study long-term changes in nutritional status and gastrointestinal (GI) functions of 15 women previously treated with radiotherapy for gynecological cancer. Two years prior to this research, these patients had been assessed twice: before external radiotherapy and 5 weeks later, at the completion of the external dose (45-50 Gy).


METHODS
Each patient was given complete clinical evaluation, consisting of dietary, physical activity and digestive symptoms questionnaires. Blood was drawn for routine clinical laboratory tests (hemoglobin, white blood cell count, creatinine, lipoproteins, glucose, total proteins, albumin, and C reactive protein). Body composition was assessed by classical anthropometric indicators and double beam X-ray absorptiometry (DEXA), while muscle strength was measured through a hand dynamometer. Resting energy expenditure (REE), obtained by indirect calorimetry, was subtracted from energy ingestion, derived from dietary records, to calculate energy balance.


RESULTS
This third evaluation included fifteen patients. A significant increase in body mass index (BMI), % body fat and waist circumference were observed in comparison to earlier evaluations. The lean compartment decreased significantly, and REE descended in parallel. Meanwhile, total energy, fat and protein intake increased, compared to previous measurements. The changes in bowel habits observed during radiotherapy persisted at this third evaluation, with the exception of diarrhea, which was less reported. Abdominal bloating and rectal symptoms were the most prevalent complaints.


CONCLUSIONS
After radiation treatment for gynecological cancer, patients gained more body fat than expected in Chilean women around menopause. In spite of high protein ingestion, the loss of fat-free mass observed during radiation treatment was not recovered along with weight increase. This is probably associated with infrequent physical activity, both during and after treatment, and hyperphagia.
Pía de la Maza
María
M
Institute of Nutrition and Food Technology (INTA)-University of Chile, Santiago, Chile. mpmaza@uec.inta.uchile.cl
Agudelo
Gloria Maria
GM
Yudin
Talía
T
Gattás
Vivian
V
Barrera
Gladys
G
Bunout
Daniel
D
Hirsch
Sandra
S
D015502:Absorptiometry, Photon; D000273:Adipose Tissue / Q000378:metabolism*; D001823:Body Composition / Q000528:radiation effects*; D015519:Bone Density / Q000528:radiation effects; D002153:Calorimetry, Indirect; D004734:Energy Metabolism / Q000528:radiation effects*; D005260:Female; D005833:Genital Neoplasms, Female / Q000532:radiotherapy; D006801:Humans; D006963:Hyperphagia / Q000139:chemically induced; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000378:metabolism; D009752:Nutritional Status; D010388:Pelvis / Q000528:radiation effects*; D011878:Radiotherapy / Q000009:adverse effects*; D015430:Weight Gain / Q000502:physiology