Abstract

BackgroundThis pilot trial aimed to study the feasibility and effects on quality of life (QOL) and well-being of short-term fasting (STF) during chemotherapy in patients with gynecological cancer.MethodsIn an individually-randomized cross-over trial patients with gynecological cancer, 4 to 6 planned chemotherapy cycles were included. Thirty-four patients were randomized to STF in the first half of chemotherapies followed by normocaloric diet (group A;n = 18) or vice versa (group B;n = 16). Fasting started 36 h before and ended 24 h after chemotherapy (60 h-fasting period). QOL was assessed by the FACIT-measurement system.ResultsThe chemotherapy-induced reduction of QOL was less than the Minimally Important Difference (MID; FACT-G = 5) with STF but greater than the MID for non-fasted periods. The mean chemotherapy-induced deterioration of total FACIT-F was 10.4 ± 5.3 for fasted and 27.0 ± 6.3 for non-fasted cycles in group A and 14.1 ± 5.6 for non-fasted and 11.0 ± 5.6 for fasted cycles in group B. There were no serious adverse effects.ConclusionSTF during chemotherapy is well tolerated and appears to improve QOL and fatigue during chemotherapy. Larger studies should prove the effect of STF as an adjunct to chemotherapy.Trial registrationThis trial was registered at clinicaltrials.gov: NCT01954836.

Highlights

  • This pilot trial aimed to study the feasibility and effects on quality of life (QOL) and well-being of short-term fasting (STF) during chemotherapy in patients with gynecological cancer

  • As weight loss may negatively affect the prognosis of cancer patients with cancer, short- term fasting (STF), which is not related to long-term weight loss and its adverse effects has been introduced in basic research as a potential add-on treatment during chemotherapy [14]

  • Experimental data consistently show that the combination of short-term fasting cycles with chemotherapy is effective in enhancing chemotherapeutic tolerability and efficacy and has high translational potential [1]

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Summary

Introduction

This pilot trial aimed to study the feasibility and effects on quality of life (QOL) and well-being of short-term fasting (STF) during chemotherapy in patients with gynecological cancer. As weight loss may negatively affect the prognosis of cancer patients with cancer, short- term fasting (STF), which is not related to long-term weight loss and its adverse effects has been introduced in basic research as a potential add-on treatment during chemotherapy [14]. The present pilot study was designed to assess the effect of a 60 h-STF on quality of life (QOL) in patients with gynecological cancer under chemotherapy. Based on the experimental evidence we hypothesized that fasting increases QOL and reduces fatigue during chemotherapy compared to standard nutrition [15]. By means of an explorative cross-over design we compared QOL, general well-being and fatigue across all fasted chemotherapy cycles versus all chemotherapy cycles with normocaloric diet

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