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Impact of nutritional parameter variations during definitive chemoradiotherapy in locally advanced oesophageal cancer
Aude Di Fiore1, Stéphane Lecleire1, Alice Gangloff1
1Digestive Oncology Unit, Department of Gastroenterology, Rouen University Hospital, 1 rue de Germont, 76031 Rouen Cedex, France.
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.
Aim:
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).
Conclusion:
Significant variations of nutritional parameters occurred during chemoradiotherapy with a worse impact on response and survival.
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