Impact of nutritional status in the era of FOLFOX/FIRI-based chemotherapy

Abstract

Background: The nutritional status plays a pivotal role during anticancer therapy. This study analyzed whether nutritional status influences the outcomes in the era of FOLFOX/FIRI therapy. Methods: The patients were divided into two groups according to whether the nutritional status was well (serum albumin level ≥3.8g/dL or a ≥1.0g/dL increase as compared with the value before chemotherapy) or not before and 2 and 6months after the start of chemotherapy. Chemotherapy-related adverse events (AE), treatment effect, and compliance were evaluated according to the nutritional status. The progression-free survival (PFS) and overall survival (OS) were assessed based on the nutritional status at 6months. Results: Between 2010 and 2013, data on 108 consecutive patients were analyzed. At 2months after chemotherapy, the hematotoxicic AE and the value of tumor markers did not differ significantly. The non-hematotoxic AE were less frequent in patients in the well-nourished group (grade 2, 15.9 vs. 38.5%, p<0.01). Based on the nutritional status at 6months after chemotherapy, the hematotoxicic AE (grade 3, 9 vs. 19.5%, p=0.03) and non-hematotoxic AE (grade 2, 31.3 vs. 51.2%, p=0.04; grade 3, 6.0 vs. 24.4%, p<0.01) were less frequent, and the median CEA value (5.3 vs. 27.75mg/L, p<0.01) was significantly lower in the well-nourished group. The median PFS (364 vs. 233days, p<0.01) and 5-year OS (26.5 vs. 11.1%, p=0.01) are significantly better in the well-nourished group. Conclusions: The well-nourished at initial 6months may predict a better treatment response and fewer adverse events in FOLFOX/FIRI chemotherapy.