Impact of nutritional parameter variations during definitive chemoradiotherapy in locally advanced oesophageal cancer.
BACKGROUND
Undernutrition is frequently observed in patients with a locally advanced oesophageal carcinoma. However, variations of nutritional parameters during chemoradiotherapy have not been thoroughly investigated.


OBJECTIVE
To evaluate the characteristics and the impact of nutritional variations during treatment.


METHODS
Weight loss, body mass index (BMI), serum albumin level and daily food intake at baseline and during treatment (T1=week 1; T2=week 5 or 8; T3=week 11) were retrospectively analyzed in 101 patients with oesophageal carcinoma.


RESULTS
Significant variations occurred during chemoradiotherapy with a decrease in serum albumin level (p<0.001), body mass index (p<0.001) and weight (p<0.001). Response rate to treatment was significantly lower in patients with undernutrition at T1 (p=0.05), from T1 to T2 (p=0.01) and from T1 to T3 (p=0.04). Median overall survival was 25 months in patients with persistent undernutrition from T1 to T2 vs 42 months in wellnourished patients from T1 to T2 and those malnourished only at T1 or T2 (p=0.05). In responders, patients presenting with a lower weight or a lower food intake from T1 to T3 had worse survival (33 vs 59 months, p<0.001 and 29 vs 61 months, p=0.001, respectively).


CONCLUSIONS
Significant variations of nutritional parameters occurred during chemoradiotherapy with a worse impact on response and survival.
Digestive Oncology Unit, Department of Gastroenterology, Rouen University Hospital, 1 rue de Germont, 76031 Rouen Cedex, France. Electronic address: frederic.di-fiore@chu-rouen.fr.
Aude
A
Di Fiore
Digestive Oncology Unit, Department of Gastroenterology, Rouen University Hospital, 1 rue de Germont, 76031 Rouen Cedex, France.
Stéphane
S
Lecleire
Digestive Oncology Unit, Department of Gastroenterology, Rouen University Hospital, 1 rue de Germont, 76031 Rouen Cedex, France.
Alice
A
Gangloff
Oncology Department, Centre de Lutte Contre le Cancer Henri-Bequerel, Rouen University Hospital, 1 rue de Germont, 76031 Rouen Cedex, France.
Olivier
O
Rigal
Radiotherapy Department, Centre de Lutte Contre le Cancer Henri-Bequerel, Rouen University Hospital, 1 rue de Germont, 76031 Rouen Cedex, France.
Ahmed
A
Benyoucef
Digestive Oncology Unit, Department of Gastroenterology, Rouen University Hospital, 1 rue de Germont, 76031 Rouen Cedex, France.
Valérie
V
Blondin
Digestive Oncology Unit, Department of Gastroenterology, Rouen University Hospital, 1 rue de Germont, 76031 Rouen Cedex, France.
David
D
Sefrioui
Digestive Oncology Unit, Department of Gastroenterology, Rouen University Hospital, 1 rue de Germont, 76031 Rouen Cedex, France.
Martine
M
Quiesse
Digestive Oncology Unit, Department of Gastroenterology, Rouen University Hospital, 1 rue de Germont, 76031 Rouen Cedex, France.
Isabelle
I
Iwanicki-Caron
Digestive Oncology Unit, Department of Gastroenterology, Rouen University Hospital, 1 rue de Germont, 76031 Rouen Cedex, France.
Pierre
P
Michel
Digestive Oncology Unit, Department of Gastroenterology, Rouen University Hospital, 1 rue de Germont, 76031 Rouen Cedex, France; Oncology Department, Centre de Lutte Contre le Cancer Henri-Bequerel, Rouen University Hospital, 1 rue de Germont, 76031 Rouen Cedex, France.
Frédéric
F
Di Fiore
D000230:Adenocarcinoma / Q000150:complications / Q000628:therapy*; D000368:Aged; D015992:Body Mass Index; D001835:Body Weight; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000628:therapy*; D059248:Chemoradiotherapy; D015331:Cohort Studies; D018450:Disease Progression; D018572:Disease-Free Survival; D004435:Eating; D002149:Energy Intake; D004938:Esophageal Neoplasms / Q000150:complications / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D012709:Serum Albumin; D016896:Treatment Outcome
D012709:Serum Albumin
Chemoradiotherapy; Nutritional parameters variations; Oesophageal cancer