Is cachexia associated with chemotherapy toxicities in gastrointestinal cancer patients? a prospective study

• Autor(a) principal: Fayh, Ana Paula Trussardi
• Data de Publicação: 2019
• Outros Autores: Rocha, Ilanna Marques Gomes da, Marcadenti, Aline, Medeiros, Galtieri Otávio Cunha de, Bezerra, Ricardo Andrade, Rego, Juliana Florinda de Mendonça, Gonzalez, Maria Cristina
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UFRN
• Texto Completo: https://repositorio.ufrn.br/handle/123456789/55476; http://dx.doi.org/10.1002/jcsm.12391
• topic: Sarcopenia; cachexia; muscle attenuation; chemotherapy toxicity; nutritional status; gastrointestinal cancer

BackgroundChemotherapy is an effective treatment with good clinical response in patients with cancer. However, it cancause exacerbated toxicities in patients and consequently change the course of treatment. Some factors may interfere withthis toxicity such as body composition, especially in gastrointestinal cancer. The aim of this study was to evaluate the effectsof body composition, nutritional status, and functional capacity scale in predicting the occurrence of toxicities in gastrointes-tinal cancer patients during chemotherapy treatment.MethodsThis is a prospective study with gastrointestinal cancer patients at the beginning of chemotherapy treatment.Sarcopenia and muscle attenuation were assessed using the skeletal muscle index from computerized tomography by measur-ing cross-sectional areas of the L3tissue (cm2/m2). Cachexia was graded according to involuntary weight loss associated withsarcopenia. Nutritional status was assessed by using anthropometric evaluation and Patient-Generated Subjective Global As-sessment. Functional capacity was evaluated by handgrip strength and Eastern Cooperative Oncology Group (ECOG) Perfor-mance Status scale. Haematological gastrointestinal and dose-limiting toxicities (DLTs) were defined according to NationalCancer Institute Common Toxicity Criteria. The associations among sarcopenia, cachexia, nutritional status, and functional ca-pacity with DLT were assessed by univariate and multivariate Cox regression model.ResultsA total of60patients were evaluated (55% male,60.9±14.0years) and followed up for a mean of55days. Mostpatients had normal weight (44.2%) and good ECOG Performance Status (≤1) at baseline (78%). During the chemotherapy pe-riod, the most prevalent toxicities were diarrhoea, nausea, and anorexia, but the presence of DLT was similar between cycles(P>0.05). Cachexia was associated with a higher toxicity manifested by diarrhoea (P=0.02), nausea (P=0.02), and anorexia(P<0.01andP=0.03at Cycles1and2, respectively). Sarcopenic and cachetic individuals experienced more toxicities and DLTduring chemotherapy. The only factors associated with DLT in the multivariate Cox regression analyses including the presenceof metastasis and the chemotherapy protocol were cachexia and the ECOG scale (P<0.001for both).ConclusionsCachexia and ECOG score may identify patients with an increased risk for developing severe toxicity events dur-ing chemotherapy treatment for gastrointestinal cancer