Associations between nutritional status, weight loss, radiotherapy treatment toxicity and treatment outcomes in gastrointestinal cancer patients.
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.
Hill
Amanda
A
School of Exercise and Nutrition Sciences, Deakin University, Burwood Highway, Burwood VIC 3125, Melbourne, Australia.
Kiss
Nicole
N
Hodgson
Belinda
B
Crowe
Timothy C
TC
Walsh
Adam D
AD
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