scholarly journals Nutritional Status During Concurrent Chemoradiotherapy (CCRT) Is Critical for Survival in Patients with Locally Advanced Unresectable Esophageal Cancer

2019 ◽  
Vol 105 (1) ◽  
pp. E185-E186
Author(s):  
T.T. Huang ◽  
S.H. Li ◽  
H.I. Lu ◽  
Y.H. Chen ◽  
C.M. Lo ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Nutritional Status ◽  
Concurrent Chemoradiotherapy ◽  
Locally Advanced

scholarly journals Effect of Whole-course Nutrition Management on Patients with Esophageal Cancer Undergoing Concurrent Chemoradiotherapy: A Randomized Control Trial (P05-031-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Yanfang Qiu ◽  
Jie You ◽  
Quanjun Lv ◽  
Ling Yuan
Keyword(s):  
Quality Of Life ◽  
Esophageal Cancer ◽  
Nutritional Status ◽  
Concurrent Chemoradiotherapy ◽  
Nutrition Support ◽  
Control Group ◽  
Observation Group ◽  
Skin Reactions ◽  
Nutrition Management

Abstract Objectives Malnutrition is the most common complication of patients with esophageal cancer, and can lead to poor prognosis and death. It has been shown that good nutritional status can help improve patient outcomes and reduce complications. In the absence of specific evidence of the effect of nutrition on patients with esophageal cancer, the purpose of this study was to investigate the effect of total nutrition management on the prognosis and complications of patients with esophageal cancer through a randomized controlled trial. Methods 96 patients with esophageal cancer concurrent chemoradiation were randomized to observation group (treated by whole-nutrition management from the Nutrition Support Group (NST)) and control group (treated by the general nutritional method) for 6 weeks approximately. Dietary survey, Patient-Generated Subjective Global Assessment (PG-SGA), body measurement, blood index, quality of life survey and psychological condition survey were assessed at baseline and every week/at the end of the study. Complications, the completion rates of therapy, short-term efficacy evaluation as well as clinical outcomes were measured before discharge. Results A total of 85 subjects completed the study (observation group = 45, control group = 40). There were significantly different in the changes in serum albumin, prealbumin, and total protein between two groups throughout the trial (P < 0.05). Radioactive esophagitis, skin symptom of the complications, the roles, emotional functions, social functions, and general health status in the quality of life were statistically different before and after the intervention (P < 0.05). The difference in the change of other indicators was not statistically significant. Conclusions Whole-course nutrition management can improve the nutritional status of patients with concurrent chemoradiotherapy of esophageal cancer, reduce the severity of radiation esophagitis and radiation skin reactions, improve the quality of life and relieve their depressive symptoms. Funding Sources Wu Jieping Medical Foundation Special Fund for Clinical Research of 2017.

Can induction chemotherapy improve dysphagia in locally advanced esophageal/GEJ cancer?

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 148-148
Author(s):  
Elizabeth Won ◽  
David H. Ilson ◽  
Jessica Herrera ◽  
Yelena Yuriy Janjigian ◽  
Geoffrey Yuyat Ku ◽  
...  
Keyword(s):  
Weight Loss ◽  
Esophageal Cancer ◽  
Nutritional Status ◽  
Induction Chemotherapy ◽  
Locally Advanced ◽  
Concurrent Chemoradiation ◽  
Tube Placement ◽  
Average Weight ◽  
Feeding Tubes ◽  
Presenting Symptoms

148 Background: Dysphagia is one of the most common presenting symptoms in esophageal cancer (EC) and can lead to significant nutritional decline, which is associated with increased toxicity and poor outcomes. Invasive feeding tubes or endoscopic stents are frequently used to improve nutrition in this setting. We evaluated the role of induction chemotherapy prior to concurrent chemoradiation as presurgical treatment in improving dysphagia. Methods: Retrospective analysis of 4 prospective studies conducted at MSKCC with induction chemotherapy followed by concurrent chemoradiation and surgery in locally advanced esophageal/GEJ cancer. Regimens included cisplatin/paclitaxel, cisplatin/irinotecan, and cisplatin/irinotecan/bevacizumab. Dysphagia was graded prospectively using a validated dysphagia scale. Response of dysphagia and nutritional status to induction chemotherapy was evaluated. Results: Of 161 patients (pts) undergoing induction chemotherapy, [median age 59(21-76), KPS 90 (70-100), 77% adenocarcinoma], 121 (76%) had dysphagia, with 59(37%) having grade 2 dysphagia or higher (20% Stage II, 80% Stage III). 6(4%) required EGD dilatation/stent and none required feeding tube placement prior to treatment. 22% patients had>10% body weight loss prior to treatment and average weight loss in all pts was 4.3kg. After induction chemotherapy, 104 (64%) had improvement in dysphagia. This was associated with a weight gain in 42% of pts. Only 7(4%) had worsening dysphagia after induction chemotherapy: 4/7 required feeding tubes (2% of all pts), 2/7 underwent endoscopic dilatation or stent (1% of all pts). 6/7 of these pts with worsening dysphagia had poor short term outcomes after induction treatment: 2/7 progressive disease, 3/7 unresectable at surgery, 1/7 post-operative death. Conclusions: Induction chemotherapy prior to concurrent chemoradiation for locally advanced esophageal cancer can effectively improve swallowing and nutritional status, while mitigating need for feeding tubes or stents in patients with significant dysphagia. Post-induction dysphagia may be prognostic and merits further investigation.

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