A clinical study on the nutritional status of patients with locally advanced rectal cancer during chemo-radiotherapy

Abstract

BACKGROUND: Rectal cancer is one of the most common gastrointestinal malignancies, and most cases include locally advanced cancers at the time of diagnosis (stage II/III).

OBJECTIVES: The purpose of this study is to observe the dynamic changes in the nutritional status of patients with locally advanced rectal cancer during concurrent radiation therapy and chemotherapy and to evaluate the nutritional risk and incidence of malnutrition in these patients.

METHODS: A total of 60 patients with locally advanced rectal cancer were enrolled in this study. The 2002 Nutritional Risk Screening and Patient-Generated Subjective Global Assessment Scales (PG-SGA) were used to assess nutritional risk and status. The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (QLQ) C30 and QLQ-CR38 scales were used for the quality of life evaluation. Toxicity was evaluated using the CTC 3.0 standard.

RESULTS: The incidence of nutritional risk among these 60 patients was 38.33% (23 of 60) before and 53% (32 of 60) after concurrent chemo-radiotherapy. There were 28 patients in the well-nourished group, with a PG-SGA score of <2 points, and 17 patients in the nutrition-changed group, with a PG-SGA score of <2 points before and 2 points during and after chemo-radiotherapy. In the well-nourished group, the incidence of nausea, vomiting and diarrhea mentioned in the summary was lower and the expectations for the future (according to the QLQ-CR30 and QLQ-CR28 scales) were higher than in the undernourished group. The undernourished group required delayed treatment more often and experienced nausea, vomiting and diarrhea earlier and for longer than the well-nourished group. These results show that the quality of life of the well-nourished group was better.

CONCLUSIONS: There is a degree of nutritional risk and deficiency in patients with locally advanced rectal cancer. Chemoradiotherapy increases the incidence of nutritional risk and deficiencies