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Impact of weight loss on cancer patients’ quality of life at the beginning of the chemotherapy

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Abstract

Purpose

Among the prognostic factors relevant to the condition of oncological patients, nutritional status (NS) has the greatest single impact on quality of life (QL). The goals of our study were to evaluate the influence of NS, weight loss (WL), and the presence of cachexia, prior to the initiation of chemotherapy, on the patient’s QL.

Methods

Adult patients (aged ≥ 18 years) diagnosed with solid tumours for whom chemotherapy was started between April 2016 and June 2017 were eligible for inclusion in the study. They were asked to complete a QL questionnaire (Functional Assessment of Cancer Treatment (FACT-G)) at the beginning. The presence or absence of cachexia was evaluated at the outset, following the definition proposed by Fearon and nutritional assessment by the Patient-Generated Subjective Global Assessment (PG-SGA) scale.

Results

A total of 177 patients completed the FACT-G, the 60% receiving curative therapy. At the start of the treatment, 58.2% of patients had experienced WL, with an average of 4.4 ± 7.4%, and 19% were at risk of malnutrition. Patient who presented cachexia at diagnosis, were treated with palliative intention, had a Nutriscore ≥ 5 points or presented malnutrition in accordance with PG-SGA had a poorer QL (p < 0.05). Greater WL was associated with a worsened QL (p = 0.001). Breast cancer patients presented an inverse correlation between the %WL and the initial score in the FACT-G (r = − 0.304, p = 0.023), whereas no such correlation was observed for the other types of tumour (r = − 0.012, p = 0.892).

Conclusions

These results underline the relation of NS before starting chemotherapy and QL. Greater WL was associated with a worsened QL, especially in women with breast cancer.

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Acknowledgements

The authors of the work want to thank the hospital day and Pharmacy Service staff (specially Begoña Tortajada Goitia) and patients for their collaboration. We thank the research team at the Agencia Sanitaria Costa del Sol for their support. The present study is part os a PhD. Research programme being conducted at the University of Málaga. This work was partially presented at the III announcement of the SEFH-ROVI to the development of the hospital pharmacy, getting one award to best work. The award has been delivered at the 64 National Congress of the Spanish Society of Hospital Pharmacy held in Seville, Spain, in October 2019.

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Authors and Affiliations

  1. Área de Farmacia y Nutrición, Hospital Costa del Sol, Agencia Sanitaria Costa del Sol, A7, km. 187, 29603, Marbella, Málaga, Spain

    Elena Álvaro Sanz, Jimena Abilés & Margarita Garrido Siles

  2. Oncology service, Hospital Costa del Sol, A7, km 187, 29603, Marbella, Málaga, Spain

    Elísabeth Pérez Ruíz & Julia Alcaide García

  3. UGCI Oncología Médica, Hospitales Universitarios Regional y Virgen de la Victoria, IBIMA, P° Limonar, 2, Bq3, 5°A, Málaga, Spain

    Antonio Rueda Domínguez

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  1. Elena Álvaro Sanz
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Correspondence to Margarita Garrido Siles.

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The study protocol was approved by the Agencia Sanitaria Costa del Sol Ethics Committee. All patients provided written informed consent.

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Álvaro Sanz, E., Abilés, J., Garrido Siles, M. et al. Impact of weight loss on cancer patients’ quality of life at the beginning of the chemotherapy. Support Care Cancer 29, 627–634 (2021). https://doi.org/10.1007/s00520-020-05496-9

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