TY - JOUR
T1 - Colorectal cancer
T2 - intrinsic characteristics modulate cancer energy expenditure and the risk of cachexia
AU - Ravasco, Paula
AU - Monteiro-Grillo, Isabel
AU - Camilo, Maria
N1 - Funding Information:
Keywords: Colorectal cancer, Radiotherapy, Resting energy expenditure, Nutritional status, Nutritional intake, Cancer stage, Histology, Response to treatment. This study was supported by a grant from the “Fundac¸ão para a Ciência e Tecnologia” (RUN 437). We wish to express our gratitude to the invaluable collaboration of the Radiotherapy Medical, Nursing and Technical staff. Correspondence to: Paula Ravasco Unidade de Nutric¸ão e Metabolismo Instituto de Medicina Molecular Faculdade de Medicina de Lisboa Avenida Prof. Egas Moniz 1649-028 Lisboa Portugal email: [email protected]
Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2007/7
Y1 - 2007/7
N2 - Purpose: To conduct a prospective longitudinal study in colorectal cancer (CRC) patients: 1) to evaluate resting energy expenditure (REE), weight/dietary intake changes, and response to treatment, taking into consideration cancer stage and histology; 2) to determine their potential interrelations; and 3) to quantify the relative contributions to REE of cancer/nutrition/treatment. Patients and Methods: 101 CRC patients proposed for neoadjuvant radiotherapy (RT) were evaluated before and after RT: REE (indirect calorimetry measurements), percentage of weight loss, usual diet (diet history), current diet (24 hour recall), and treatment response. Results: REE was higher in Stages III/IV versus I/II, at the RT onset (p < 0.002) and end (p = 0.02), and in moderately/poorly/undifferentiated cancers vs well differentiated (onset, p < 0.001) and (RT end, p = 0.01); weight/intake reductions were also greater in Stages III/IV versus I/II (p < 0.01) and in moderately/poorly/ undifferentiated cancers versus well differentiated (p < 0.02). According to patients' response to treatment, REE was increased in Stage III/IV (p < 0.005) and Grade 2/3 histology (p < 0.003). In nonresponders, REE increased 7.2 ± 1.3 kcal/kg/day and decreased 2.8 ± 0.4 kcal/kg/day in responders. REE changes were not-significantly influenced by weight/intake. Relative contributions to baseline REE were determined in 25 percent by stage, in 25 percent by histology, in 3 percent by intake and in 4 percent by weight loss. At the end of RT, higher REE was attributed in 26 percent to stage, in 27 percent to histology, in 30 percent to nontreatment response, in 9 percent to intake, and in 8 percent to weight loss. Conclusions: In this CRC patient population, higher metabolic rates were mainly determined by the tumor burden and aggressiveness in association with response to treatment clearly disclaiming the effect of weight loss and/or dietary intake reductions.
AB - Purpose: To conduct a prospective longitudinal study in colorectal cancer (CRC) patients: 1) to evaluate resting energy expenditure (REE), weight/dietary intake changes, and response to treatment, taking into consideration cancer stage and histology; 2) to determine their potential interrelations; and 3) to quantify the relative contributions to REE of cancer/nutrition/treatment. Patients and Methods: 101 CRC patients proposed for neoadjuvant radiotherapy (RT) were evaluated before and after RT: REE (indirect calorimetry measurements), percentage of weight loss, usual diet (diet history), current diet (24 hour recall), and treatment response. Results: REE was higher in Stages III/IV versus I/II, at the RT onset (p < 0.002) and end (p = 0.02), and in moderately/poorly/undifferentiated cancers vs well differentiated (onset, p < 0.001) and (RT end, p = 0.01); weight/intake reductions were also greater in Stages III/IV versus I/II (p < 0.01) and in moderately/poorly/ undifferentiated cancers versus well differentiated (p < 0.02). According to patients' response to treatment, REE was increased in Stage III/IV (p < 0.005) and Grade 2/3 histology (p < 0.003). In nonresponders, REE increased 7.2 ± 1.3 kcal/kg/day and decreased 2.8 ± 0.4 kcal/kg/day in responders. REE changes were not-significantly influenced by weight/intake. Relative contributions to baseline REE were determined in 25 percent by stage, in 25 percent by histology, in 3 percent by intake and in 4 percent by weight loss. At the end of RT, higher REE was attributed in 26 percent to stage, in 27 percent to histology, in 30 percent to nontreatment response, in 9 percent to intake, and in 8 percent to weight loss. Conclusions: In this CRC patient population, higher metabolic rates were mainly determined by the tumor burden and aggressiveness in association with response to treatment clearly disclaiming the effect of weight loss and/or dietary intake reductions.
KW - Cancer stage
KW - Colorectal cancer
KW - Histology
KW - Nutritional intake
KW - Nutritional status
KW - Radiotherapy
KW - Response to treatment
KW - Resting energy expenditure
UR - http://www.scopus.com/inward/record.url?scp=34547520749&partnerID=8YFLogxK
U2 - 10.1080/07357900701208873
DO - 10.1080/07357900701208873
M3 - Article
C2 - 17661205
AN - SCOPUS:34547520749
SN - 0735-7907
VL - 25
SP - 308
EP - 314
JO - Cancer Investigation
JF - Cancer Investigation
IS - 5
ER -
