Abstract
BackgroundThe nutritional status plays a pivotal role during anticancer therapy. This study analyzed whether nutritional status influences the outcomes in the era of FOLFOX/FIRI therapy.MethodsThe patients were divided into two groups according to whether the nutritional status was well (serum albumin level ≥ 3.8 g/dL or a ≥ 1.0 g/dL increase as compared with the value before chemotherapy) or not before and 2 and 6 months after the start of chemotherapy. Chemotherapy-related adverse events (AE), treatment effect, and compliance were evaluated according to the nutritional status. The progression-free survival (PFS) and overall survival (OS) were assessed based on the nutritional status at 6 months.ResultsBetween 2010 and 2013, data on 108 consecutive patients were analyzed. At 2 months after chemotherapy, the hematotoxicic AE and the value of tumor markers did not differ significantly. The non-hematotoxic AE were less frequent in patients in the well-nourished group (grade 2, 15.9 vs. 38.5%, p < 0.01). Based on the nutritional status at 6 months after chemotherapy, the hematotoxicic AE (grade 3, 9 vs. 19.5%, p = 0.03) and non-hematotoxic AE (grade 2, 31.3 vs. 51.2%, p = 0.04; grade 3, 6.0 vs. 24.4%, p < 0.01) were less frequent, and the median CEA value (5.3 vs. 27.75 mg/L, p < 0.01) was significantly lower in the well-nourished group. The median PFS (364 vs. 233 days, p < 0.01) and 5-year OS (26.5 vs. 11.1%, p = 0.01) are significantly better in the well-nourished group.ConclusionsThe well-nourished at initial 6 months may predict a better treatment response and fewer adverse events in FOLFOX/FIRI chemotherapy.
Highlights
The nutritional status plays a pivotal role during anticancer therapy
The aim of this study was to analyze whether nutritional status influences the occurrence of adverse events, continuance of chemotherapy, and survival in the era of FOLFOX/FORFIRI therapy
Participants Between May 2010 and January 2013, FOLFOX/FOLFIRI-based chemotherapy was given to 157 consecutive patients with colorectal cancer
Summary
This study analyzed whether nutritional status influences the outcomes in the era of FOLFOX/FIRI therapy. Innovations in combination chemotherapy regimens (FOLFOX/FORFIRI plus targeted agents) for colorectal metastasis have facilitated the control of tumor progression in patients with unresectable disease [1,2,3]. Most clinical studies have focused on the effects of chemotherapy, the nutritional status of patients during chemotherapy is an important factor [1,2,3]. Cancer-related malnutrition is Recently, nutritional support has been shown to enhance the response to anticancer treatment, and early nutritional support contributes to patients’ survival [7,8,9]. The aim of this study was to analyze whether nutritional status influences the occurrence of adverse events, continuance of chemotherapy, and survival in the era of FOLFOX/FORFIRI therapy
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