- Email: [email protected]
Effects of chemotherapy on resting energy expenditure (REE) in patients with nonhodgkin's lymphoma (NHL): Result of a sequential study
p.113 EFFECTS OF CHEMOTHERAPY 0~ RESTING ENERGY EXPENDITURE (REE) IN PATIENTS WITH NONHODGKIN’SLYMPHOMA (NHL) : RESULT OF A SEQUENTIAL STUDY -J.Delarue,E.Lerebours,H.Tflly, A Rfmbert, P. Hochafn, H. Piguet, R. Colfn - GBPDN, Centre H. Becquerel , ROUEN , FRANCE. Chemotherapymay modify REE in cancer patients by a double effect on the tumor and on the host. The respective role of these 2 factors is still debated. During treatment of NHL with sequential induction chemotherapy the tumoral mass reduction is mostly achieved during the first course. So the aim of this study was to compare the REE modifications observed durfng 3 successive chemotherapy courses in. NHL patients in order to assess indirectly the metabolic changes induced b the cytotoxfc effects of drugs on the tumor. The study included 10 NHL adult patients r' 6 M, 4 F, mean age 49.7 yrs) receiving 5 day chemotherapycourses every 3 to 4 weeks ; the 3 chemotherapycourses (CHOP-Bleo)included the same drugs. REE was evaluated with indirect calorimetry (Beckman MMC Horizon) during each course first within the 2 days before chemotherapy (DO) and then on days 2, 3 and 5. Results : Complete remission was achieved in 6 patients and an incomplete remfssfon in 4 patfents. REE levels are ;;dicated in the ;;ble (Mean+ SEM). D5 03 REE (Kcal/day) 131/ 104 ll3B‘fi74 1094 z,99
1272 97 1190 + 81 1348 2 59
1385 131 1074'+ 72 1325 z 59
1218 117 1195’+ 65 1358 z 90
Initial REE value at DO represents94 + 6 % of the theoreticalREE. REE at DO was lower during C2 and C3 than Cl (p < 0.01). fie REE profile was significantlydifferent between the 3 courses : Cl induced a significantREE decrease at 03 and D5 in comparisonwith the REE increase observed during C3 fp < 0.05), REE profile was intermediateduring C2. Conclusion : In NHL, REE modificationsinduced by chemotherapyare significantlydffferent between the first course and the 2 others. The REE decrease observed only during Cl may be regarded as the metabolic result of the effect of chemotherapyon the tumor.
P.114
RESTING ENEZGY EXPENDITURE (REX?)CjrHOST AND TUMOR IS SIMILAR IN RATS WITH METHYLCHOLANTHRENE (MCA) INDUCED SARCOMA. HR Freund, M MuggiaSullam, MW Kim,WT Chance, JE Fischer. Hebrew University - Hadassah Medical School, Jerusalem, Israel, and the University of Cincinnati Medical Center, Cincinnati, Ohio. Results are conflicting or ill defined as to the REE of tumor-bearing hosts, and the partition of energy costs between host and tumor. Body weight (BW) tumor weight and REX were measured weekly in 12 free feeding normal and 22 MCA-induced sarcoma bearing Fischer 344 rats, during 6-B weeks of tumor growth and for the 6 weeks following removal of the tumor. Tumor bearing rats demonstrated a marked hypophagia, carcass wasting and massive tumor growth. Neither the presence and growth of a tumor, nor its removal, resulted in any change in REE beyond the normal range for nontumor bearing rats (kcallkg124 hrs). BW (g) REE
implant 23029 160211
Week+3 27024 170217
Week+6 30925 161212
Tumor weight did not affect REX: Tumor wt(g) Control 5.5+3-l 2226 REE 163213 170+10 162210
excis 249227
3744 161216
Week-3 268215 173218
Week-6 306+14 163220
6928 161511
In the rat-MCA tumor model there is no change in REE during tumor growth or follotjing its removal, suggesting that host and tumor carry similar input, proportional to their relative weight, into the total combined REX.
111
1272 97 1190 + 81 1348 2 59
1385 131 1074'+ 72 1325 z 59
1218 117 1195’+ 65 1358 z 90
Initial REE value at DO represents94 + 6 % of the theoreticalREE. REE at DO was lower during C2 and C3 than Cl (p < 0.01). fie REE profile was significantlydifferent between the 3 courses : Cl induced a significantREE decrease at 03 and D5 in comparisonwith the REE increase observed during C3 fp < 0.05), REE profile was intermediateduring C2. Conclusion : In NHL, REE modificationsinduced by chemotherapyare significantlydffferent between the first course and the 2 others. The REE decrease observed only during Cl may be regarded as the metabolic result of the effect of chemotherapyon the tumor.
P.114
RESTING ENEZGY EXPENDITURE (REX?)CjrHOST AND TUMOR IS SIMILAR IN RATS WITH METHYLCHOLANTHRENE (MCA) INDUCED SARCOMA. HR Freund, M MuggiaSullam, MW Kim,WT Chance, JE Fischer. Hebrew University - Hadassah Medical School, Jerusalem, Israel, and the University of Cincinnati Medical Center, Cincinnati, Ohio. Results are conflicting or ill defined as to the REE of tumor-bearing hosts, and the partition of energy costs between host and tumor. Body weight (BW) tumor weight and REX were measured weekly in 12 free feeding normal and 22 MCA-induced sarcoma bearing Fischer 344 rats, during 6-B weeks of tumor growth and for the 6 weeks following removal of the tumor. Tumor bearing rats demonstrated a marked hypophagia, carcass wasting and massive tumor growth. Neither the presence and growth of a tumor, nor its removal, resulted in any change in REE beyond the normal range for nontumor bearing rats (kcallkg124 hrs). BW (g) REE
implant 23029 160211
Week+3 27024 170217
Week+6 30925 161212
Tumor weight did not affect REX: Tumor wt(g) Control 5.5+3-l 2226 REE 163213 170+10 162210
excis 249227
3744 161216
Week-3 268215 173218
Week-6 306+14 163220
6928 161511
In the rat-MCA tumor model there is no change in REE during tumor growth or follotjing its removal, suggesting that host and tumor carry similar input, proportional to their relative weight, into the total combined REX.
111