- Email: [email protected]
PP068-MON THE EFFECT OF ORAL NUTRITIONAL SUPPLEMENTATION INCLUDING EPA IN RECTAL CANCER PATIENTS UNDERGOING PREOPERATIVE CHEMORADIOTHERAPY (CRT)
Nutrition and cancer II PP068-MON THE EFFECT OF ORAL NUTRITIONAL SUPPLEMENTATION INCLUDING EPA IN RECTAL CANCER PATIENTS UNDERGOING PREOPERATIVE CHEMORADIOTHERAPY (CRT) D. Kilic1 , Y. Pak1 , M. Oguz2 . 1 Department of Radiation Oncology, 2 Department of General Surgery, Gazi University Faculty of Medicine, Ankara, Turkey Rationale: To analyze whether oral nutritional supplementation (ONS) including EPA in addition to the actual standard protocol may have a role on the toxicity, QOL, tumor response and prognosis in locally advanced rectal cancer patients (LARCP). Methods: Prospectively, 40 LARCP undergoing preop CRT in addition to ONS including EPA (240 ml tetras twice daily) were included (Group EPA). They were compared to another 40 control patients (Group C) according to toxicity, quality of life (QOL, EORTC), nutritional status, the pathological complete response (pCR), diseasefree- and overall survival (DFS & OS). Chi-square tests, non-parametric tests of dependent/related samples were used for comparisons. Survival curves were created by Kaplan Meier, compared with log-rank. Cox proportional hazards model was used to analyze for prognosis. Results: Grade 2 or more diarrhea and GI toxicity occurred in 55 and 80% (p = 0.03), and 40 and 92% (p = 0.001) of the EPA and C groups, respectively. At the end of CRT, 6 and 32% of patients in the EPA and C group were malnourished (p = 0.044). Although the baseline QOL scores of the each group were similar, significant differences in both the functional and symptom scales in favor of EPA were observed at the end. pCR rate was achieved 37 and 20% in EPA and C groups. Statistically significant differences were observed in OS and DFS rates in favor of EPA (p < 0.001). pCR, group and angiolymphatic invasion status were found to be prognostic on DFS & OS. The risk of local recurrence was 4 times higher for Group C. Conclusion: EPA (2 tetras/day) was found to be effective to decrease the toxicity of CRT and preserve the QOL. Further randomized studies are required to determine its prognostic role. The preliminary results were presented at V. International Nutrition & Dietetics Congress, April 12 15, 2006, Turkey. Disclosure of Interest: None Declared.
PP069-MON BIOELECTRICAL IMPEDANCE PHASE ANGLE: PREDICTOR OF CELL DISTURBANCE, METABOLISM AND PRIORITY FOR NUTRITIONAL INTERVENTION? P. Ravasco1 , A.I. Almeida1 , C. Ferreira1 , I. Monteiro Grillo2 , M. Camilo1 . 1 Unit of Nutrition & Metabolism, Institute Molecular Medicine & Laboratory of Nutrition, Faculty of Medicine of the University of Lisbon, 2 Radiotherapy Department, University Hospital of Santa Maria, Lisboa, Portugal Rationale: Cancer and undernutrition may result in disturbed electric tissue properties, translated in altered phase angle (PA). This pilot study aimed to assess the predictive value of bioelectrical impedance PA
165 in identifying cancer patients with major priority for nutritional intervention. Methods: We included 26 ambulatory pts with different cancers and stages. Nutritional assessment was performed with the validated Patient-Generated Subjective Global Assessment (PG-SGA). PA values were assessed by tetrapolar multifrequency bioelectrical impedance (Biodynamics 450® ) and compared with age/sex reference percentiles. PG-SGA scores were expressed as median (interquartile range); comparisons were made using nonparametric tests. Results: Undernutrition was found in 38% of pts, and 71% had indication for urgent nutritional intervention. PA < 5th percentile was prevalent in undernourished pts and with indication for urgent nutritional intervention (44%). Median PG-SGA intervention score was significantly higher in pts with a PA < 5th percentile vs a PA > 5th percentile [12.5 (8.5 17.5) vs 4 (2 7), p = 0.005]. Median PG-SGA scores on food intake, symptoms and functional capacity were worse in pts with a PA < 5th percentile vs patients with PA > 5th percentile (p < 0.05). Overall, PA < 5th percentile did predict a significantly worse PGSGA score (p = 0.005). No significant differences were found on PG-SGA B, C & D scores. Conclusion: A PA < 5th percentile was associated with critical need for nutrition intervention. PA integration in clinical practice may be of great value; while simple and easy to use, it provides key information on cell disturbance and metabolism; this information may be useful as a first approach to prioritize the critical need of nutritional intervention and symptom management. Disclosure of Interest: None Declared.
PP070-MON THE IMPACT OF NON-CONTRACTILE TISSUE FOR THE AREA OF THE PSOAS MAJOR MUSCLE ON COMPUTED TOMOGRAPHY IMAGE N. Mori1 , T. Higashiguchi1 , A. Ito1 , A. Futamura1 , T. Watanabe2 , A. Ishikawa3 . 1 Department of Surgery and Palliative Medicine, Fujita Health University School of Medicine, Toyoake, 2 Department of Surgery, 3 Department of Internal Medicine, Chita City Hospital, Chita, Japan Rationale: We previously pointed out that the area of the psoas major muscle (PMMA) by tracing the outline of the muscle on computed tomography (CT) is a quicker and simpler indicator of the progress of cancer cachexia. Aim of this study was to evaluate the impact of noncontractile tissue increased in cachexia, for our method. For that, the PMNA obtained from the contour was compared with the area based on CT values, which is less susceptible to non-contractile tissue and more accurately reflect the amount of muscle. Methods: A retrospective analysis was performed in 24 cancer patients with abdominal malignancies (15 male; 66.7±7.5 yrs old; stomach: n = 9, colon: n = 10, pancreas: n = 5) who underwent abdominal CT scans at initial diagnosis while in non-cachectic status and follow-up while in severe cachexia. Axial CT image at the top level of the left iliac crest corresponding to the height of the L4 was obtained. PMNA (Area-A) was measured by tracing the contour of the muscle using image analysis
PP069-MON BIOELECTRICAL IMPEDANCE PHASE ANGLE: PREDICTOR OF CELL DISTURBANCE, METABOLISM AND PRIORITY FOR NUTRITIONAL INTERVENTION? P. Ravasco1 , A.I. Almeida1 , C. Ferreira1 , I. Monteiro Grillo2 , M. Camilo1 . 1 Unit of Nutrition & Metabolism, Institute Molecular Medicine & Laboratory of Nutrition, Faculty of Medicine of the University of Lisbon, 2 Radiotherapy Department, University Hospital of Santa Maria, Lisboa, Portugal Rationale: Cancer and undernutrition may result in disturbed electric tissue properties, translated in altered phase angle (PA). This pilot study aimed to assess the predictive value of bioelectrical impedance PA
165 in identifying cancer patients with major priority for nutritional intervention. Methods: We included 26 ambulatory pts with different cancers and stages. Nutritional assessment was performed with the validated Patient-Generated Subjective Global Assessment (PG-SGA). PA values were assessed by tetrapolar multifrequency bioelectrical impedance (Biodynamics 450® ) and compared with age/sex reference percentiles. PG-SGA scores were expressed as median (interquartile range); comparisons were made using nonparametric tests. Results: Undernutrition was found in 38% of pts, and 71% had indication for urgent nutritional intervention. PA < 5th percentile was prevalent in undernourished pts and with indication for urgent nutritional intervention (44%). Median PG-SGA intervention score was significantly higher in pts with a PA < 5th percentile vs a PA > 5th percentile [12.5 (8.5 17.5) vs 4 (2 7), p = 0.005]. Median PG-SGA scores on food intake, symptoms and functional capacity were worse in pts with a PA < 5th percentile vs patients with PA > 5th percentile (p < 0.05). Overall, PA < 5th percentile did predict a significantly worse PGSGA score (p = 0.005). No significant differences were found on PG-SGA B, C & D scores. Conclusion: A PA < 5th percentile was associated with critical need for nutrition intervention. PA integration in clinical practice may be of great value; while simple and easy to use, it provides key information on cell disturbance and metabolism; this information may be useful as a first approach to prioritize the critical need of nutritional intervention and symptom management. Disclosure of Interest: None Declared.
PP070-MON THE IMPACT OF NON-CONTRACTILE TISSUE FOR THE AREA OF THE PSOAS MAJOR MUSCLE ON COMPUTED TOMOGRAPHY IMAGE N. Mori1 , T. Higashiguchi1 , A. Ito1 , A. Futamura1 , T. Watanabe2 , A. Ishikawa3 . 1 Department of Surgery and Palliative Medicine, Fujita Health University School of Medicine, Toyoake, 2 Department of Surgery, 3 Department of Internal Medicine, Chita City Hospital, Chita, Japan Rationale: We previously pointed out that the area of the psoas major muscle (PMMA) by tracing the outline of the muscle on computed tomography (CT) is a quicker and simpler indicator of the progress of cancer cachexia. Aim of this study was to evaluate the impact of noncontractile tissue increased in cachexia, for our method. For that, the PMNA obtained from the contour was compared with the area based on CT values, which is less susceptible to non-contractile tissue and more accurately reflect the amount of muscle. Methods: A retrospective analysis was performed in 24 cancer patients with abdominal malignancies (15 male; 66.7±7.5 yrs old; stomach: n = 9, colon: n = 10, pancreas: n = 5) who underwent abdominal CT scans at initial diagnosis while in non-cachectic status and follow-up while in severe cachexia. Axial CT image at the top level of the left iliac crest corresponding to the height of the L4 was obtained. PMNA (Area-A) was measured by tracing the contour of the muscle using image analysis