title: Associations between nutritional status, weight loss, radiotherapy treatment toxicity and treatment outcomes in gastrointestinal cancer patients.
abstract: OBJECTIVE
  Patients with gastrointestinal cancers are susceptible to nutritional deterioration which may be compounded by radiotherapy treatment toxicities. This study aimed to determine whether nutritional status at radiotherapy commencement or changes in nutritional status throughout radiotherapy were associated with treatment toxicity and outcomes in gastrointestinal cancer patients.
  
  
  METHODS
  Seventy-three gastrointestinal cancer patients receiving curative radiotherapy underwent medical record audits assessing body weight, radiotherapy toxicity, unplanned treatment breaks or hospital admissions and completion of prescribed treatment/s. Nutritional status was assessed in a subset of patients (n = 11) using the Patient-Generated Subjective Global Assessment tool.
  
  
  RESULTS
  Seventy-five percent of patients lost weight throughout radiotherapy. Weight loss was significantly greater in patients experiencing unplanned radiotherapy breaks (-3.1% vs -1.6%, p < 0.05) and in patients not completing prescribed chemotherapy (-3.3% vs -1.6%, p < 0.05). Toxicity severity was strongly correlated with Patient-Generated Subjective Global Assessment score (rho = 0.839, p < 0.001) and was increased in patients experiencing unplanned admissions compared to those without admission (42.1% vs 9.3% with grade 3 toxicity respectively, p < 0.001).
  
  
  CONCLUSIONS
  Deterioration in nutritional status during radiotherapy (as measured by weight loss) may be associated with poorer short-term treatment outcomes in gastrointestinal cancer patients. Patient numbers were too small to definitively determine the effect of nutritional status at radiotherapy commencement or changes in nutritional status throughout radiotherapy (defined by PG-SGA) on treatment outcomes. Further research is required to investigate this in larger, longer-term studies.
authors: School of Exercise and Nutrition Sciences, Deakin University, Burwood Highway, Burwood VIC 3125, Melbourne, Australia.
authors: Amanda
authors: A
authors: Hill
authors: Nicole
authors: N
authors: Kiss
authors: Belinda
authors: B
authors: Hodgson
authors: Timothy C
authors: TC
authors: Crowe
authors: Adam D
authors: AD
authors: Walsh
mesh_terms: D000368:Aged; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000150:complications* / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000150:complications*; D008875:Middle Aged; D009752:Nutritional Status / Q000528:radiation effects*; D011446:Prospective Studies; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss