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Lucas, Amalorpavamari
- Nutritional Status and Functional Assessment of Anorexia, Cachexia Including Quality of Life (QoL) in Patients with Gastrointestinal Malignancies Undergoing Chemotherapy
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Authors
Affiliations
1 Assistant Professor, College of Nursing, CMC, Vellore, Tamil Nadu, IN
2 Professor, College of Nursing, CMC, Vellore, Tamil Nadu, IN
3 Charge Nurse, Hemato-Oncology Ward, CMC, Vellore, Tamil Nadu, IN
4 Chemotherapy Nurse Coordinator, Department of Medical Oncology, CMC, Vellore, Tamil Nadu, IN
1 Assistant Professor, College of Nursing, CMC, Vellore, Tamil Nadu, IN
2 Professor, College of Nursing, CMC, Vellore, Tamil Nadu, IN
3 Charge Nurse, Hemato-Oncology Ward, CMC, Vellore, Tamil Nadu, IN
4 Chemotherapy Nurse Coordinator, Department of Medical Oncology, CMC, Vellore, Tamil Nadu, IN
Source
Asian Journal of Nursing Education and Research, Vol 12, No 2 (2022), Pagination: 201-207Abstract
Malnutrition is an overlooked domain of concern among patients with GI malignancies especially, while undergoing chemotherapy. Poor nutrition deleteriously impacts treatment outcomes, performance status and eventually the QoL. A quantitative descriptive research approach was used to assess the nutritional status and the functional assessment of anorexia/cachexia including QoL among patients with GI malignancies undergoing chemotherapy. A total of 111 adult patients were enrolled using consecutive sampling technique. Data were collected using PGSGA and FAACT questionnaires. The findings revealed that based on PGSGA, 50.5% were moderately and 23.4% were severely malnourished. 73.90% had a PGSGA point score of ≥ 9. Based on SCRINIO classification, 20.7% were symptomatically cachexic and 58.6% were symptomatic precachexic. Hemoglobin was < 11.9g/dL in 63% of patients. 45% had a performance status (ECOG) score of 1. The overall mean FAACT score was moderate (108.6822.82). Statistically significant, strong negative correlation existed between nutritional status and FAACT (r=-0.710, p-0.000). Statistically significant difference was found in the mean nutritional status based on ECOG score (p-0.000), SCRINIO classification (p-0.000), hemoglobin level (p-0.001), BMI (p-0.020), family income (p-0.035) and the duration of last chemotherapy received (p-0.035). Also, statistically significant difference was seen in the mean FAACT score based on ECOG score (p-0.000), SCRINIO classification (p-0.000), family income (p-0.001), hemoglobin level (p-0.004) and BMI status (p-0.030). The study reveals that majority of GI cancer patients undergoing chemotherapy are moderately to severely malnourished and have a moderate functional status and QoL. The study emphasizes the critical need for ongoing preemptive nutritional assessment/interventions, improved symptom management and individualized dietary counseling to cancer patients.Keywords
GI Malignancies, Chemotherapy, Nutritional Status, Functional Assessment of Anorexia and Cachexia, Quality of Life.References
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- Mascaretti F, Evangelista J. Nutritional Assessment in Gastrointestinal Tumors: News from the 2020 ASCO and ESMO World GI Meetings.
- Gastrointestinal Disorders. 2020 Sep;2(3):310–7.
- Jamshidi S, Hejazi N, Zimorovat AR. Nutritional Status in Patients with Gastrointestinal Cancer in Comparison To Other Cancers In Shiraz, Southern Iran: a Case-Control Study. World J Plast Surg. 2018 May;7(2):186–92.
- Arends J, Baracos V, Bertz H, Bozzetti F, Calder PC, Deutz NEP, et al. ESPEN expert group recommendations for action against cancer-related malnutrition. Clin Nutr. 2017 Oct;36(5):1187–96.
- Zietarska M, Krawczyk-Lipiec J, Kraj L, Zaucha R, Malgorzewicz S. Nutritional status assessment in colorectal cancer patients qualified to systemic treatment. Contemp Oncol (Pozn). 2017;21(2):157–61.
- Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol. 1982 Dec;5(6):649–55.
- Bozzetti F, Mariani L. Defining and classifying cancer cachexia: a proposal by the SCRINIO Working Group. JPEN J Parenter Enteral Nutr. 2009 Aug;33(4):361–7.
- Yoo SH, Oh EG, Youn MJ. The Reliability and Validity of Patient-Generated Subjective Global Assessment (PG-SGA) in Stroke Patients. Journal of Korean Academy of Adult Nursing. 2016 Jun 16;21(6):559–69.
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- Barret M, Malka D, Aparicio T, Dalban C, Locher C, Sabate J-M, et al. Nutritional status affects treatment tolerability and survival in metastatic colorectal cancer patients: results of an AGEO prospective multicenter study. Oncology. 2011;81(5–6):395–402.
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- da Rocha IMG, Marcadenti A, de Medeiros GOC, Bezerra RA, Rego JF de M, Gonzalez MC, et al. Is cachexia associated with chemotherapy toxicities in gastrointestinal cancer patients? A prospective study. J Cachexia Sarcopenia Muscle. 2019 Apr;10(2):445–54.
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- Prathima S, Murthy M, Maka VV, Paibhavi PR, Reddy H, Vungarala S. Assessment of nutritional status and quality of life among cancer patients undergoing chemotherapy. Annals of Oncology. 2019 Nov 1;30:ix149–50.
- Zaid ZA, Jackson K, Phd L, Kandiah M. Relationship between quality of life and nutritional status in colorectal cancer patients undergoing chemotherapy. Malaysian Journal of Nutrition. 2017 Jan 1;23:375–84.
- Lis CG, Gupta D, Lammersfeld CA, Markman M, Vashi PG. Role of nutritional status in predicting quality of life outcomes in cancer--a systematic review of the epidemiological literature. Nutr J. 2012 Apr 24;11:27.
- Santos IM, Mendes L, Carolino E, Santos CA. Nutritional Status, Functional Status, and Quality of Life - What is the Impact and Relationship on Cancer Patients? Nutr Cancer. 2020 Oct 29;1–14.
- Maeda H, Sato M, Kobayashi M, Takiguchi N, Yoshikawa T, Yoshino S, et al. Validity of the Japanese version of functional assessment of cancer therapy-gastric (FACT-Ga) and its sensitivity to ascites volume change: a retrospective analysis of Japanese clinical trial participants. Support Care Cancer. 2016 Nov;24(11):4515–21.1. Marshall KM, Loeliger J, Nolte L, Kelaart A, Kiss NK. Prevalence of malnutrition and impact on clinical outcomes in cancer services: A comparison of two time points. Clin Nutr. 2019 Apr;38(2):644–51.
- Mascaretti F, Evangelista J. Nutritional Assessment in Gastrointestinal Tumors: News from the 2020 ASCO and ESMO World GI Meetings.
- Gastrointestinal Disorders. 2020 Sep;2(3):310–7.
- Jamshidi S, Hejazi N, Zimorovat AR. Nutritional Status in Patients with Gastrointestinal Cancer in Comparison To Other Cancers In Shiraz, Southern Iran: a Case-Control Study. World J Plast Surg. 2018 May;7(2):186–92.
- Arends J, Baracos V, Bertz H, Bozzetti F, Calder PC, Deutz NEP, et al. ESPEN expert group recommendations for action against cancer-related malnutrition. Clin Nutr. 2017 Oct;36(5):1187–96.
- Zietarska M, Krawczyk-Lipiec J, Kraj L, Zaucha R, Malgorzewicz S. Nutritional status assessment in colorectal cancer patients qualified to systemic treatment. Contemp Oncol (Pozn). 2017;21(2):157–61.
- Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol. 1982 Dec;5(6):649–55.
- Bozzetti F, Mariani L. Defining and classifying cancer cachexia: a proposal by the SCRINIO Working Group. JPEN J Parenter Enteral Nutr. 2009 Aug;33(4):361–7.
- Yoo SH, Oh EG, Youn MJ. The Reliability and Validity of Patient-Generated Subjective Global Assessment (PG-SGA) in Stroke Patients. Journal of Korean Academy of Adult Nursing. 2016 Jun 16;21(6):559–69.
- Ribaudo JM, Cella D, Hahn EA, Lloyd SR, Tchekmedyian NS, Von Roenn J, et al. Re-validation and shortening of the Functional Assessment of Anorexia/Cachexia Therapy (FAACT) questionnaire. Qual Life Res. 2000;9(10):1137–46.
- Sharma D, Kannan R, Tapkire R, Nath S. Evaluation of Nutritional Status of Cancer Patients during Treatment by Patient-Generated Subjective Global Assessment: a Hospital-Based Study. Asian Pac J Cancer Prev. 2015;16(18):8173–6.
- Alsaleh K, Almomen FA, Altaweel A, Barasain O, Alqublan A, Binsalamah A, et al. Malnutrition in cancer patients receiving chemotherapy in a single oncology center. Journal of Nature and Science of Medicine. 2021 Apr 1;4(2):170.
- Nitichai N, Angkatavanich J, Somlaw N, Voravud N, Lertbutsayanukul C. Validation of the Scored Patient-Generated Subjective Global Assessment (PG-SGA) in Thai Setting and Association with Nutritional Parameters in Cancer Patients. Asian Pac J Cancer Prev. 2019 Apr 29;20(4):1249–55.
- Barret M, Malka D, Aparicio T, Dalban C, Locher C, Sabate J-M, et al. Nutritional status affects treatment tolerability and survival in metastatic colorectal cancer patients: results of an AGEO prospective multicenter study. Oncology. 2011;81(5–6):395–402.
- Zhao W, Shi HP. The Prevalence of Malnutrition in Patients Suffering from Different Cancers by Three Classification Methods (P05-041-19). Curr Dev Nutr. 2019 Jun 13;3(Suppl 1):nzz030.P05-041-19.
- da Rocha IMG, Marcadenti A, de Medeiros GOC, Bezerra RA, Rego JF de M, Gonzalez MC, et al. Is cachexia associated with chemotherapy toxicities in gastrointestinal cancer patients? A prospective study. J Cachexia Sarcopenia Muscle. 2019 Apr;10(2):445–54.
- Zhou T, Yang K, Thapa S, Fu Q, Jiang Y, Yu S. Validation of the Chinese version of functional assessment of anorexia-cachexia therapy (FAACT) scale for measuring quality of life in cancer patients with cachexia. Support Care Cancer. 2017 Apr;25(4):1183–9.
- Prathima S, Murthy M, Maka VV, Paibhavi PR, Reddy H, Vungarala S. Assessment of nutritional status and quality of life among cancer patients undergoing chemotherapy. Annals of Oncology. 2019 Nov 1;30:ix149–50.
- Zaid ZA, Jackson K, Phd L, Kandiah M. Relationship between quality of life and nutritional status in colorectal cancer patients undergoing chemotherapy. Malaysian Journal of Nutrition. 2017 Jan 1;23:375–84.
- Lis CG, Gupta D, Lammersfeld CA, Markman M, Vashi PG. Role of nutritional status in predicting quality of life outcomes in cancer--a systematic review of the epidemiological literature. Nutr J. 2012 Apr 24;11:27.
- Santos IM, Mendes L, Carolino E, Santos CA. Nutritional Status, Functional Status, and Quality of Life - What is the Impact and Relationship on Cancer Patients? Nutr Cancer. 2020 Oct 29;1–14.
- Maeda H, Sato M, Kobayashi M, Takiguchi N, Yoshikawa T, Yoshino S, et al. Validity of the Japanese version of functional assessment of cancer therapy-gastric (FACT-Ga) and its sensitivity to ascites volume change: a retrospective analysis of Japanese clinical trial participants. Support Care Cancer. 2016 Nov;24(11):4515–21.