Evaluation of nutritional parameters in prechemotherapy of oncology patients in a service of the Unified Health System

Autor: Tatiana Caldeira Pontes, Paula Calixto Batistela Diniz, Fauzia de Fátima Naime, Carolina Graziani Vital, Arianne Renata Eyzaguirre Velasquez, Karina Emi Yamada, Carla Andressa Rodrigues Dias, Ligia Rabello De Almeida, Raphael Francisco Azuaga Neto, Valéria Urresti Orias, Rafael Sanches Ferreira, Maria Stella Sa Granja De Abreu, Leandro Maritan de Almeida, Brigitte M. Van Eyll, Thiago D'Alvia, Hezio Jadir Fernandes, Silvia Regina Graziani, Cassia Costa, Fabiano Garcia Vanderlinde, Ricardo Oliveira Da Fonseca
Rok vydání: 2017
Předmět:
Zdroj: Journal of Clinical Oncology. 35:e21628-e21628
ISSN: 1527-7755
0732-183X
DOI: 10.1200/jco.2017.35.15_suppl.e21628
Popis: e21628 Background: Pre-chemotherapy nutritional evaluation is fundamental strategy as predictive factor for the possibility of response to oncological treatment and treatment-related toxicity. As in the Unified Health System patients usually arrive for evaluation with advanced disease, we believe that medical evaluation of the nutritional parameters is important in the therapeutic decision. Methods: From October 2015 through July 2016, we evaluated 210 patients referred for cancer treatment at the Arnaldo Vieira de Carvalho Cancer Institute in São Paulo (Brazil), which is an Institution that exclusively serves the Unified Health System. We evaluated the clinical parameters of weight and height, for estimation of BMI; evaluation the muscle of the fold of the thumb; and laboratory parameters as hemoglobin, lymphocytes, albumin, PCR (C-reactive protein) levels. We included 54 patients with gastrointestinal tract carcinoma; 32 colorectal carcinoma, 14 gastric carcinoma, 8 esophageal carcinoma, 12 lung carcinoma, 16 head and neck carcinomas, 38 breast carcinoma, 6 cervical carcinoma, 4 uterine carcinoma, 6 ovarian carcinoma, 4 malignant melanoma carcinoma, 2 soft tissue sarcomas, 10 prostate carcinoma, and 4 bladder carcinoma. Results: We found significant changes in the clinical nutritional parameters in patients with gastric, esophageal, lung and head and neck carcinomas, whose hemoglobin levels were among the mean normal values of 8.9 g/dL (6.5-10.3 g/dL), the lymphocytes levels were 850/mm3 (450-1200/mm3), the albumin levels were 3.2 g/dL (2.3-3.8 g/dL), the PCR levels were 126 mg/L (80-620 mg/L) and the Adductor muscle of the thumb were < 1 mm. Although all the evaluated patients presented advanced stages in diagnosis, the tumors of breast, prostate, uterine body, malignant melanoma and bladder did not present any significant alterations in the nutritional state. Conclusions: Our strategy shows that nutrition evaluation is an easy-to-use instrument, and opens the possibility of using in the therapeutic decision in patients with severe mal nutrition and compromising the general condition, since palliative chemotherapy has no impact on the overall survival of this population.
Databáze: OpenAIRE
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