Estado nutricional en pacientes con cáncer cervico-uterino al ingreso hospitalario / Nutritional status in patients with cervical cancer at hospital admission

RESUMEN Existe un gran aumento de la frecuencia de desnutrición en pacientes con cáncer, sin embargo, la información disponible sobre la evaluación del estado de nutrición en pacientes con cáncer cervicouterino (CaCu) es limitada. Material y métodos: Estudio retrospectivo, observacional, transversal. Se realizó una revisión de expedientes clínicos, en los cuales, el estado nutricional fue evaluado con una valoración nutricional institucional que incluye parámetros antropométricos (peso, IMC, pliegue cutáneo tricipital (PCT), circunferencia media de brazo (CMB), % masa grasa), bioquímicos (albúmina, hemoglobina, linfocitos) y dietéticos (consumo energético y proteico). Resultados: Se incluyeron 195 expedientes de pacientes con CaCu. La frecuencia de los estadios tempranos fue de 51.8% y en esas pacientes existió una prevalencia de desnutrición determinada por la albúmina de 9.75% y de 25.13 % de acuerdo a los linfocitos, incrementándose a 41.18% de desnutrición de acuerdo al PCT en estadios avanzados. Se encontraron correlaciones estadísticamente significativas entre el estadio clínico y la ingesta calórica (r= −0.3062 p< 0.0001), la concentración de albúmina (r= −0.4732 p< 0.0001) y la circunferencia media de brazo (r= −0.2564 p= 0.0003). Conclusión: El estado nutricional en estadios tempranos del CaCu no presenta alteraciones, mientras que en estadios intermedios y avanzados la alteración del estado nutricional aumenta.

ABSTRACT There is a high frequency of malnutrition in cancer patients; however, available information on the assessment of nutritional status in patients with cervical cancer is limited. Material and methods: We conducted a retrospective, observational, cross-sectional study. Clinical records were reviewed; nutritional status was evaluated with the institutional nutritional evaluation tool that includes anthropometric (weight, BMI, tricipital skin fold, medium arm circumference, fat mass %), biochemical (albumin, hemoglobin, lymphocytes) and diet parameters (energy and protein consumption). Results: We included the records of 195 patients with cervical cancer. The frequency of the early stage cancer was 51.8% and in those patients there was a prevalence of malnutrition, determined by albumin, of 9.75% and 25.13% according to the lymphocytes, increasing to 41.18% measured by tricipital skin fold among patients with advanced-stage cancer. Statistically significant correlations were found between clinical stage and caloric intake (r= −0.3062 p< 0.0001), albumin concentration (r= −0.4732 p <0.0001) and mean arm circumference (r = −0.2564 p= 0.0003). Conclusion: The nutritional status in early stages of CaCu does not present alterations, while in intermediate and advanced stages the alteration of nutritional status may increase.

Effects of Dietary Components During and After Concomitant Chemoradiotherapy, Radiotherapy, or Sequential Chemoradiotherapy to the Abdominopelvic Area.

Radiotherapy is a fundamental part of the treatment of pelvic neoplasms. Up to 90% of patients develop gastrointestinal symptoms as a result of acute injury to the small and large intestine, particularly in the mucosa. Radiotherapy leads to atrophy of the intestinal epithelium, acute crypt inflammation, inflammatory infiltration of the epithelium, malabsorption of lactose, and biliary salts as well as alterations in pancreatic enzymes and biliary salts, resulting in the malabsorption syndrome and dysbiosis. The most commonly reported symptoms of pelvic radiation disease include changes in bowel habits (94%), decreased fecal consistency (80%), frequency of bowel movements (74%), bowel urgency (39%), and fecal incontinence (37%). Although nutritional interventions with dietary modifications have been reported to prevent and treat gastrointestinal symptoms, the evidence remains inconclusive.