TY - JOUR
T1 - Influence of chemoradiotherapy on nutritional status in locally advanced rectal cancer
T2 - Prospective multicenter study
AU - Yamano, Tomoki
AU - Tomita, Naohiro
AU - Sato, Takeo
AU - Hayakawa, Kazushige
AU - Kamikonya, Norihiko
AU - Matoba, Shuichiro
AU - Uki, Akiyoshi
AU - Baba, Hideo
AU - Oya, Natsuo
AU - Hasegawa, Hirotoshi
AU - Shigematsu, Naoyuki
AU - Hiraoka, Masahiro
AU - Shimada, Mitsuo
AU - Noda, Masafumi
AU - Sakai, Yoshiharu
AU - Sato, Hirohiko
AU - Saegusa, Makoto
AU - Takeuchi, Masahiro
AU - Oguchi, Masahiko
AU - Oya, Masatoshi
AU - Watanabe, Masahiko
N1 - Funding Information:
This study was supported by TCOG with funding from Taiho Pharmaceutical Co, Ltd, under a study contract. Taiho had no role in this study other than funding. NT received grants from Taiho, Chugai, Sysmex, Eli Lilly, Bayer, and Covidien. KH received a grant from Taiho and personal fees from Daiichi-Sankyo and Yakult Honsha. HB received grants from Taiho, Eli Lilly, Ono, Chugai, Linical, Shionogi, MSD, Merck Serono, Covidien, Yakult Honsha, and Shin Nippon Biomedical Laboratories, and personal fees from Taiho, Eli Lilly, Ono, Chugai, and Takeda. NO received personal fees from Taiho. HH received grants from Taiho, Chugai, and Yakult Honsha. MS received grants from Taiho and Yakult Honsha. YS received grants from Taiho and Yakult Honsha. MSaegusa received grants from Taiho and personal fees from Daiichi-Sankyo and Yakult Honsha. MO received grants from Kaken, Chugai, Taiho, Sanofi, Ono, Takeda, Asahi-Kasei, and Yakult Honsha. MW received grants from Taiho, Chugai, and Yakult Honsha. All authors contributed to the conception and design of the research and to the the acquisition, analysis, and interpretation of the data. TY drafted the manuscript. All authors critically revised the manuscript, agreed to be fully accountable for ensuring the integrity and accuracy of the work, and read and approved the final manuscript.
Funding Information:
The authors acknowledge the members of the Tokyo Cooperative Oncology Group (TCOG; Ms. Kisa, Mr. Masuda, and Ms. Odagiri) for managing the SAMRAI-2 trial and helping with the publication of this manuscript. They also acknowledge the members involved in the SAMRAI-2 trial, other than the authors listed in this article, for data collection. This study was supported by TCOG with funding from Taiho Pharmaceutical Co, Ltd, under a study contract. Taiho had no role in this study other than funding. NT received grants from Taiho, Chugai, Sysmex, Eli Lilly, Bayer, and Covidien. KH received a grant from Taiho and personal fees from Daiichi-Sankyo and Yakult Honsha. HB received grants from Taiho, Eli Lilly, Ono, Chugai, Linical, Shionogi, MSD, Merck Serono, Covidien, Yakult Honsha, and Shin Nippon Biomedical Laboratories, and personal fees from Taiho, Eli Lilly, Ono, Chugai, and Takeda. NO received personal fees from Taiho. HH received grants from Taiho, Chugai, and Yakult Honsha. MS received grants from Taiho and Yakult Honsha. YS received grants from Taiho and Yakult Honsha. MSaegusa received grants from Taiho and personal fees from Daiichi-Sankyo and Yakult Honsha. MO received grants from Kaken, Chugai, Taiho, Sanofi, Ono, Takeda, Asahi-Kasei, and Yakult Honsha. MW received grants from Taiho, Chugai, and Yakult Honsha. All authors contributed to the conception and design of the research and to the the acquisition, analysis, and interpretation of the data. TY drafted the manuscript. All authors critically revised the manuscript, agreed to be fully accountable for ensuring the integrity and accuracy of the work, and read and approved the final manuscript.
Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2020/9
Y1 - 2020/9
N2 - Objective: The aim of this study was to investigate the influence of chemoradiotherapy (CRT) on nutritional status and the association between changes in nutritional status and clinical outcomes (treatment completion, adverse events, perioperative complications, and relapse-free survival [RFS]) in patients with locally advanced rectal cancer (LARC). Methods: In this multicenter, phase II study, 41 patients with LARC underwent CRT for 5 wk, followed by a 6- to 8-wk interval before surgery. Body weight, body mass index (BMI), lean body mass, serum albumin, and prealbumin levels were measured before (pre-), during, and after CRT, and before surgery. Changes in these data and scores on the Malnutrition Universal Screening Tool (MUST) were calculated based on pre-CRT status. Results: Twelve patients (29.3%) experienced body weight loss (BWL) ≥5% (defined as malnutrition) after CRT (P < 0.001) and before surgery (P = 0.035). Significant changes were seen in serum albumin levels and BMI during and after CRT (P < 0.001), and in MUST scores after CRT (P = 0.003) and before surgery (P = 0.035). Treatment completion was significantly associated with BWL (P = 0.028), MUST score (P = 0.013), and decreased serum albumin level (P = 0.001) after CRT. Regarding adverse events, MUST score before surgery (P = 0.009) and serum albumin level after CRT (P = 0.002) were significantly associated with diarrhea severity. Serum albumin level during CRT was associated with the onset of neutropenia (P = 0.005). No association was found between BWL and RFS. Conclusions: These findings suggest that malnutrition and changes in nutritional status are not only commonly observed after CRT, but also associated with treatment completion and adverse events.
AB - Objective: The aim of this study was to investigate the influence of chemoradiotherapy (CRT) on nutritional status and the association between changes in nutritional status and clinical outcomes (treatment completion, adverse events, perioperative complications, and relapse-free survival [RFS]) in patients with locally advanced rectal cancer (LARC). Methods: In this multicenter, phase II study, 41 patients with LARC underwent CRT for 5 wk, followed by a 6- to 8-wk interval before surgery. Body weight, body mass index (BMI), lean body mass, serum albumin, and prealbumin levels were measured before (pre-), during, and after CRT, and before surgery. Changes in these data and scores on the Malnutrition Universal Screening Tool (MUST) were calculated based on pre-CRT status. Results: Twelve patients (29.3%) experienced body weight loss (BWL) ≥5% (defined as malnutrition) after CRT (P < 0.001) and before surgery (P = 0.035). Significant changes were seen in serum albumin levels and BMI during and after CRT (P < 0.001), and in MUST scores after CRT (P = 0.003) and before surgery (P = 0.035). Treatment completion was significantly associated with BWL (P = 0.028), MUST score (P = 0.013), and decreased serum albumin level (P = 0.001) after CRT. Regarding adverse events, MUST score before surgery (P = 0.009) and serum albumin level after CRT (P = 0.002) were significantly associated with diarrhea severity. Serum albumin level during CRT was associated with the onset of neutropenia (P = 0.005). No association was found between BWL and RFS. Conclusions: These findings suggest that malnutrition and changes in nutritional status are not only commonly observed after CRT, but also associated with treatment completion and adverse events.
KW - Adverse event
KW - Albumin
KW - Body weight
KW - Malnutrition
KW - Treatment completion
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U2 - 10.1016/j.nut.2020.110807
DO - 10.1016/j.nut.2020.110807
M3 - Article
C2 - 32402940
AN - SCOPUS:85084323352
SN - 0899-9007
VL - 77
JO - Nutrition
JF - Nutrition
M1 - 110807
ER -
