Subjective global assessment and prealbumin levels of esophageal cancer patients undergoing concurrent chemoradiotherapy.

Abstract

To evaluate the nutritional status of patients undergoing chemoradiotherapy for esophageal cancer using subjective global assessment (SGA) and association of prealbumin levels to nutritional status. A prospective study was performed on 154 patients with esophageal cancer who were treated with concurrent chemoradiotherapy at center of radiation oncology in Huai'an First People's Hospital from January 2012 to May 2013. The patients' nutritional status after receiving concurrent chemoradiotherapy were evaluated using SGA tool. Serum total protein, prealbumin, albumin and other biochemical nutrition parameters including triglyceride, total cholesterol, cholesterol and glucose were determined before beginning and after the end of radiotherapy. Malnutrition developed in 129 (83.8%) patients. According to SGA results, 16.2%, 66.2%, and 17.6% of patients were classified as A, B, or C, respectively. Loss of subcutaneous fat or muscle wasting (odds ratio [OR] 11.522); increased metabolic demand/ stress (OR 8.637); ankle, sacral edema, or ascites (OR 3.229) and weight loss ≥5% (OR 2.294) were significantly associated with malnutrition (SGA B or C; p < 0.001). Prealbumin level after the end of radiotherapy was significantly lower in patients with malnutrition (17 ± 5 g/ dl vs. 21 ± 5 g/dl, p = 0.005), but it showed no difference before beginning radiotherapy (24 ± 4 g/dl vs. 22 ± 5 g/ dl, p > 0.05). On the other hand, there was no significant difference in term of other nutrition parameters whether before beginning or after the end of radiotherapy (p > 0.05). The prevalence of malnutrition was high in esophageal cancer patients undergoing concurrent chemoradiotherapy. The results serve as a basis for implementation of nutrition intervention to patients being treated at radiotherapy departments. Prealbumin showed relation with SGA rating and should be considered as a sensitive nutritional biomarker for evaluating nutritional status of esophageal cancer patients undergoing concurrent chemoradiotherapy.