Abstract
Cancer patients (pts) undergoing chemotherapy (CT) are often at nutritional risk. The nutritional status of 102 colorectal cancer pts receiving 2, 5 day courses of (5FU/LV) was examined. Prior to CT, pts received nutritional counseling regarding their energy/protein (pro) needs and combating chemo-toxicity related complications. Pts recorded food diaries for the 3 days prior to, 5 days during, and 2 days following each CT course. Height, weight (WT), albumin (Alb), total pro, tricep skin fold (TSF), and mid-arm muscle circumference (MAMC) were collected. There were 54 males and 48 females with a mean age of 64.5 years. The mean baseline WT was 172lbs, and 122% of ideal body WT (143lbs). WT increased from baseline to the 2nd CT course (p<0.016). TSF decreased between baseline and 1st CT course (p<0.013), whereas MAMC did not change significantly from baseline. Alb and total pro were within normal range at baseline. Alb decreased from baseline to the 1st course (p<0.003). Similarly total pro decreased from baseline to the 1st (p<0.037) and 2nd (p<0.054) courses. For both 1st and 2nd courses calorie intake decreased between the period prior to CT and the 5 days during/2 days post therapy (p<0.001 and p<0.004, respectively). During the 4 time points examined, 73% to 90% of estimated energy requirements (EER) were met with the maximum intake occurring during the period prior to the 2nd course. Caloric distribution over the 2 CT courses averaged 17% pro, 51% carbohydrate, and 32% fat. Based on anthropometric and biochemical data, the colorectal cancer pts had adequate nutritional status prior to and during their CT. Despite not meeting 100% EER, pts gained WT but may have lost lean mass while undergoing CT. After only 2 courses of 5FU/LV, nutritional status has declined suggesting an important role for the dietitian in managing the nutritional status of these pts to avoid increased nutritional risk and consequences associated with further cancer CT treatment.
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