Resting energy expenditure changes after antineoplastic treatment in gynecological cancer: a prospective pilot study / Cambios en el gasto energético en reposo tras el tratamiento antineoplásico en cáncer ginecológico: estudio piloto prospectivo

Introduction: energy metabolism in cancer patients is influenced by different factors. However, the effect of antineoplastic treatment is not clear, especially in women. Objective: to evaluate resting energy expenditure (REE) by indirect calorimetry (IC) before (T0) and after (T1) first cycle period of antineoplastic therapy: radiotherapy (RT), chemotherapy (CT), and concomitant chemoradiation therapy (CRT), quality of life (QoL) and accuracy of REE were compared with international guidelines recommendations per kilogram (European Society for Clinical Nutrition and Metabolism [ESPEN]). Methods: an observational, longitudinal study was conducted in women with gynecological cancer diagnosis undergoing antineoplastic treatment: RT, CT and CRT. Weight loss, actual body weight and height were measured. REE was evaluated in T0-T1 and compared with ESPEN recommendations. Kruskal-Wallis test and Bland-Alman analysis were used to determine the agreement (± 10 % of energy predicted) of REE adjusted by physical activity (TEE) compared with ESPEN recommendations, respectively. Results: fifty-four women with cancer were included: 31.5 % (n = 17) for RT group, 31.5 % (n = 17) for CT group and 37 % (n = 20) for CRT group. REE showed statistical differences between T0 and T1 in the total population (p = 0.018), but these were not associated with anticancer therapy groups (p > 0.05). QoL had no significant changes after treatment (p > 0.05). Accuracy of 25 and 30 kcal/kg compared to TEE was less than 30 %. Conclusion: REE in women with gynecological cancer decreased after antineoplastic treatments but this is not associated with a particular antineoplastic therapy. It is needed to develop research to determine the accuracy of ESPEN recommendations with TEE estimated by IC and clinical factors in women with cancer. (AU)

Antecedentes: el metabolismo energético en pacientes con cáncer está influenciado por diferentes factores. Sin embargo, el efecto sobre el tratamiento antineoplásico no es claro, especialmente en mujeres. Objetivo: evaluar el gasto energético en reposo (GER) mediante calorimetría indirecta (CI) antes (T0) y después (T1) del primer ciclo del tratamiento antineoplásico: radioterapia (RT), quimioterapia (QT) y quimio-radioterapia concomitante (QRT), calidad de vida (CdV) y precisión del GER con las con las recomendaciones internacionales por kilogramo de peso (European Society for Clinical Nutrition and Metabolism [ESPEN]). Métodos: se realizó un estudio longitudinal, observacional en mujeres con diagnóstico de cáncer ginecológico en tratamiento antineoplásico. Se evaluó el GER en T0 y T1. Se midieron la pérdida de peso, el peso corporal y la talla. Se usaron las pruebas de Kruskal-Wallis y el análisis Bland-Altman para determinar la concordancia (± 10 % de GER) del REE ajustado por actividad física (TEE) en comparación con las recomendaciones de ESPEN. Resultados: se incluyeron 54 mujeres con cáncer; 31,5 % (n = 17) en el grupo RT, 31,5 % (n = 17) en el de QT y 37 % (n = 20) en el de QRT. GER mostró diferencias estadísticas entre T0 y T1 en la población total (p = 0,018); no se asoció con la terapia contra el cáncer (p > 0,05). La calidad de vida no tuvo cambios significativos después del tratamiento (p > 0,05). La precisión de 25 y 30 kcal/kg en comparación con TEE fue inferior al 30 %. Conclusión: el GER en mujeres con cáncer ginecológico disminuyó después del tratamiento antineoplásico, pero no se asoció a una terapia antineoplásica en particular. Es fundamental desarrollar más investigaciones que compare las recomendaciones de ESPEN y con los valores de la CI comparando más factores clínicos para ofrecer una intervención nutricional precisa (AU)

[Obesity and risk of relapse in patients with Acute Lymphoblastic Leukemia: A retrospective study]. / Obesidad y riesgo de recaídas en pacientes con Leucemia Linfoblástica Aguda: Estudio retrospectivo.

BACKGROUND: Obesity has been associated with a low-grade proinflammatory state, and it has been related to the development of cancer in general, including hematologic cancer. AIM: The present work aimed to identify the association of the diagnosis of obesity according to the body mass index (BMI) with prognostic factors of adult patients with Acute Lymphoblastic Leukemia (ALL). PATIENTS AND METHOD: This observational, retrospective study included hospitalized patients diagnosed with ALL of the B-cell lineages. BMI was estimated based on the weight and height registered on clinical records at the admission of the patients. The relapse risk and bone marrow relapse were determined, and the survival rate was measured. The statistical analysis included the Kaplan-Meier method using the log-Rank test. RESULTS: This study included 128 clinical records of patients. Weight had no significant association with relapse risk. The frequency of bone marrow relapse was 43.8%. Obesity did not impact overall survival (p = 0.640) or disease-free survival (p = 0.527). The presence of obesity does not behave as a relapse risk variable (p = 0.873). BMI with a 30 kg/m2 cut-off point did not influence relapse risk (OR 1.078). CONCLUSION: Obesity is not an independent risk factor for the prognosis of adult patients with Acute Lymphoblastic Leukemia B-lineage.