Colorectal cancer nutritional and quality-of-life parameters predict patients outcomes after radiotherapy: Long-term follow-up from a prospective randomized controlled trial

14570 Background: Long term data of our published randomized trial of nutritional therapy in colorectal cancer showed that nutritional counseling optimizes pts prognosis. This study aimed to search whether outcomes were affected by individual nutritional & Quality of Life (QoL) parameters after nutrition intervention and radiotherapy (RT). Methods: Data were obtained from the trial pts’ records: G1 (n=37) on individualized nutritional counseling & education (regular foods), G2 (n=37) ad lib+polymeric protein supplements & G3 (n=37) ad lib intake. After RT, current intake (diet history), nutritional status (PG-SGA) & QoL scores (EORTC) were evaluated; their ability to predict survival, disease outcome [loco regional recurrence (LRR), distant metastases] & late RT toxicity (permanent flatulence, abdominal distension, diarrhea) were analyzed after a median follow-up of 3.7 (2.0–5.8) yrs. Results: Energy/protein intakes had decreased in G3 (p<0.01) & increased in G1>G2, p=0.007; wasting only occurred in G3>G2 (p<0.05); QoL scores worsened in G3>G2 (p<0.05) yet improved in G1, p<0.01. On multivariate analyzis of coded time-dependent variables: poorer diet intake, nutritional wasting & worse QoL scores were associated with decreased survival (p<0.002), LRR (p=0.01), distant metastases (p=0.005) & late RT toxicity, p<0.003. Landmark analysis showed that pts with nutritional intake/status & QoL deterioration, had significantly lower survival (hazard ratio [HR]: 8.25; 95% CI 2.74–26.47; p<0.001), worse disease outcome (HR: 8.15; 95% CI 2.22–25.40; p<0.002) & more severe late RT toxicity (HR: 7.15; 95% CI 2.25–16.11; p<0.004). Conclusions: In colorectal cancer after RT, poor diet intake, wasting & deteriorated QoL look as if significant predictors of survival, treatment response & late RT toxicity; such patients are prone to a more aggressive clinical course. No significant financial relationships to disclose.