Body composition of children with cancer during treatment and in survivorship.
BACKGROUND
Malnutrition as assessed with the use of body-composition measurements is a poorly understood short- and long-term complication of childhood cancer.


OBJECTIVE
We aimed to evaluate the body composition of 2 childhood cancer cohorts as follows: 1) children currently undergoing cancer treatment and 2) childhood cancer survivors. We also aimed to compare the prevalence of obesity and undernutrition between the cancer groups and investigate the impact of cancer type on body composition.


METHODS
Eighty-two children during the treatment of cancer and 53 childhood cancer survivors were involved in the study. Height, weight, body cell mass, percentage of fat, fat mass index, and fat-free mass index were assessed. Subjects were compared with age- and sex-matched healthy controls.


RESULTS
The on-treatment group had a higher percentage of fat (P = 0.0001) and fat mass index (P = 0.0001) and a significantly lower body cell mass index (P = 0.0001) and fat-free mass index (P = 0.003) than did matched controls. The survivor group had a significantly higher percentage of fat (P = 0.03) and fat mass index (P = 0.04) and significantly lower body cell mass index (P = 0.0001) than did matched controls. The prevalence of undernutrition was high in both groups with 48% (95% CI: 36%, 60%) of the on-treatment group and 53% (95% CI: 40%, 66%) of the survivors considered undernourished. According to the percentage of fat cutoffs, significantly more on-treatment patients were obese (55%; 95% CI: 40%, 60%) than were survivors (26%; 95% CI: 14%, 38%) (P = 0.005). There were no statistically significant differences in body composition between cancer types in either the on-treatment or the survivor group.


CONCLUSIONS
Overnutrition and undernutrition are major concerns in the short and long term for children with cancer. Children treated for cancer have increased fat mass and decreased body cell mass, which are evident during treatment and in survivorship. This trial was registered at http://www.ANZCTR.org.au as ACTRN12614001279617 and ACTRN12614001269628.
Children's Nutrition Research Centre, Child Health Research Centre, School of Medicine, and alexia.murphy@uq.edu.au.
Alexia J
http://orcid.org/0000-0001-7095-3796
AJ
Murphy
Department of Dietetics and Food Service, Lady Cilento Children's Hospital, Brisbane, Australia; and.
Melinda
M
White
Children's Nutrition Research Centre, Child Health Research Centre, School of Medicine, and.
Sarah A
SA
Elliott
Oncology Service, Children's Health Queensland, Brisbane, Australia.
Liane
L
Lockwood
Queensland Children's Medical Research Institute, The University of Queensland, Brisbane, Australia; Oncology Service, Children's Health Queensland, Brisbane, Australia.
Andrew
A
Hallahan
Children's Nutrition Research Centre, Child Health Research Centre, School of Medicine, and.
Peter Sw
orcid.org/0000-0002-7848-8515
PS
Davies
D000293:Adolescent; D000328:Adult; D001823:Body Composition; D015992:Body Mass Index; D001835:Body Weight; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D002149:Energy Intake; D004734:Energy Metabolism; D005260:Female; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000150:complications*; D009369:Neoplasms / Q000150:complications* / Q000628:therapy; D009765:Obesity / Q000150:complications*; D015995:Prevalence; D011446:Prospective Studies; D015996:Survival Rate; D017741:Survivors; D055815:Young Adult
body composition; cancer; childhood cancer survivor; children; malnutrition