Abstract
Short-term calorie reduction (SCR) requires individuals to reduce their calorie intake to less than 50% of normal requirements and has shown good tolerance and potential benefits in prior studies addressing gynecological cancer patients. More studies are needed to further confirm its safety, feasibility, and effects in patients with different cancers, including hematological malignancies. This pilot cohort study with a matched-pair comparison group was registered at ClinicalTrails.gov [201810112RIND]. Adult patients diagnosed with advanced-stage diffuse large-B cell lymphoma were recruited (SCR group) and matched with one comparison patient (comparison group), each in a manner blinded to their outcomes. The SCR group undertook at least two cycles of 48 h water fast along with their chemotherapy R-CHOP. Descriptive analysis and generalized estimating equations were used to analyze the data. Six participants completed multiple cycles of SCR and were compared to their six counterparts in the comparison group. The results showed that SCR is safe and feasible in terms of a high compliance rate and stable nutritional status. The SCR was associated with benefits in post-chemotherapy hematological parameters (i.e., erythrocyte [p < 0.001] and lymphocyte counts [p < 0.001]). More randomized controlled trials are needed to validate the effects of SCR on different types of cancer populations.
Highlights
In the last 10 years, calorie reduction has been suggested as a promising nutritional intervention in adjuvant therapy for standard cancer treatment [1,2]
All 12 patients were male, Chinese, and successfully completed six cycles of R-CHOP consisting of rituximab (375 mg/m2 intravenously (i.v.)), cyclophosphamide (750 mg/m2 i.v.), doxorubicin (50 mg/m2 i.v.), vincristine (1.4 mg/m2 i.v.), and prednisolone (60 mg/m2 /day by mouth for 5 days)
If a subject agreed to participate in the study in his fourth cycle of R-CHOP out of six, the maximum number of short-term calorie reduction (SCR) cycles in which he could participate was two
Summary
In the last 10 years, calorie reduction has been suggested as a promising nutritional intervention in adjuvant therapy for standard cancer treatment [1,2]. Performing long-term calorie reduction and detecting its effects is time consuming, limiting its clinical feasibility. Long-term calorie reduction is likely to result in weight loss, compromising patients’ adherence [5] and causing worries of malnutrition in patients with cancer. Short-term calorie reduction (SCR) with a higher calorie reduction but shorter implementation duration has emerged as a novel strategy to enhance the effect of chemotherapy and reduce toxicities [3,8,9]. SCR reduces one’s normal calorie intake to below 50% for no more than one week and is arranged alongside chemotherapy. In contrast to long-term calorie reduction, SCR shows comparable safety but better tolerance and more rapid effects enhancing the
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