Nutrition and Cancer-An International Journal最新文献

Various studies have demonstrated metabolic disorders in patients with esophageal squamous cell carcinoma (ESCC), although their potential role in ESCC development remains unclear. Here, we investigated alterations in the serum and fecal metabolomes of 23 ESCC patients and 23 healthy controls using untargeted metabolomics. Further analysis identified lauric acid as a biomarker for ESCC through targeted metabolomics, with validation in 88 ESCC patients and 44 healthy controls. Then, we examined the effects and mechanisms of lauric acid on EC109 cell physiological functions. Significant alterations occurred in serum and fecal samples from ESCC patients versus healthy controls, with lipid metabolites and associated pathways showing the most pronounced changes. Lauric acid was identified as a characteristic altered metabolite and an independent risk factor for ESCC (OR = 1.71, 95% CI: 1.05-2.79, p < 0.05). Mechanistic studies demonstrated that lauric acid promotes EC109 survival, invasion, and migration by interacting with the highly expressed fatty acid receptor GPR84 in ESCC tissues. Our research provides new insights into the relationship between lipid metabolism disorders and ESCC development, suggesting that lauric acid serves as an ESCC risk factor and may offer therapeutic intervention avenues.

This study explored the effect of symptom-based individualized nutritional intervention on chemotherapy tolerance and quality of life (QOL) in patients with colorectal cancer (CRC) undergoing postoperative chemotherapy. Postoperative patients with CRC (n = 88) were randomly assigned to the control group (CG, n = 45) and intervention group (IG, n = 43) receiving conventional diet counseling and symptom-based individualized nutritional intervention, respectively, and chemotherapy tolerance, adverse effects, and QOL were compared. Participants in the IG exhibited better nutritional status at the last chemotherapy cycle, with lower Nutrition Risk Screening 2002 (2.37 ± 0.65 vs. 3.78 ± 0.65, p < 0.01) and Patient-Generated Subjective Global Assessment (6.26 ± 0.76 vs. 7.78 ± 0.70, p < 0.01) scores. Compared with CG, relative dose intensity reduction (9.3% vs. 25.89%, p = 0.02), chemotherapy regimen change (25.58% vs. 53.33%, p < 0.01), and chemotherapy delay (13.95% vs. 35.56%, p = 0.019) were lower in the IG. Nausea/vomiting (2.33% vs. 17.78%, p = 0.017), thrombocytopenia (2.33% vs. 28.89%, p < 0.01), and hand-foot syndrome (4.65% vs. 22.22%, p = 0.03) were less frequent in the IG. Participants in the IG had better QOL, with higher physical function scores at cycles 4 (67.91 ± 5.22 vs. 62.22 ± 4.02, p < 0.01) and 8 (72.71 ± 6.31 vs. 57.63 ± 4.75, p < 0.01). Individualized nutritional interventions improved chemotherapy tolerance and QOL and reduced adverse effects in this patient cohort.

Previous studies demonstrated that diabetes and hyperglycemia promote cholangiocarcinoma (CCA) progression, in vitro and in vivo. However, the predictive abilities of blood glucose levels for CCA prognosis remain unclear. This retrospective cohort analysis included 85 patients with histologically confirmed CCA at Srinagarind Hospital, Khon Kaen University, between 1998 and 2000, comprised 57 males and 28 females with a median age of 56 ± 13 years. The glucose-lymphocyte ratio (GLR) was calculated from preoperative fasting blood glucose and absolute lymphocyte counts, and the cutoff was determined using the receiver operating characteristic curve. Survival analysis revealed that higher GLR was significantly associated with shorter overall survival (P < 0.05). A higher GLR was negatively correlated with total protein, globulin, and lymphocyte counts (P < 0.05). Univariate analysis revealed that a high GLR was associated with male sex and a survival time < 6 months (P < 0.05). The multivariable Cox proportional hazard model showed that a higher GLR was an independent prognostic factor for CCA (adjusted hazard ratio: 1.887; 95% confidence interval: 1.101-3.237), alongside carbohydrate antigen 19-9, staging, neutrophil count, and histological grading. Collectively, these findings indicate that the GLR is a significant prognostic biomarker for CCA, underscoring the importance of metabolic and nutritional status in CCA management.

The nutritional status of adults before the initiation of chemotherapy in low-income countries has been poorly explored. This study aimed to determine the prevalence of malnutrition and its associated factors before initiating chemotherapy at major cancer centers in Ethiopia. A multicenter cross-sectional study was conducted from February 13 to June 4, 2024, involving 400 adults diagnosed with solid tumors. The Patient-Generated Subjective Global Assessment (PG-SGA) was used to evaluate nutritional status. A multiple ordinal logistic regression model was used to determine associated factors. The results showed that 65% (60.2 - 69.5%) of patients were malnourished. Of these, 26% exhibited moderate malnutrition, and 39% experienced severe malnutrition. The factors that increased the odds of the highest category (severe malnutrition) were male sex (adjusted odds ratio [AOR] = 1.83), lack of regular physical activity (AOR = 1.59), presence of nutrition-impact symptoms (AOR = 33.1), gastrointestinal cancer diagnosis (AOR = 3.3), stage 4 cancer (AOR = 2.2), and preexisting comorbidities (AOR = 1.96). Conversely, a history of surgery was associated with lower odds of malnutrition (AOR = 0.46). Overall, two-thirds of adults with cancer were malnourished. Therefore, early nutritional assessment, management of nutritional impact symptoms, increased cancer awareness for early detection, and regular physical activity are recommended.

Radiotherapy is a common cancer treatment, and concurrent nutritional interventions can maintain nutritional status and improve clinical and supportive care outcomes. However, optimal nutritional interventions during radiotherapy are not firmly established. Herein, we assessed the feasibility, safety, and efficacy of dietary counseling interventions without oral nutrition supplements on health outcomes in adults receiving radiotherapy for cancer in a systematic review. Prospective clinical trials that implemented nutritional counseling interventions during radiotherapy were identified from four databases from inception through December 2023. Feasibility, safety, and efficacy were extracted from 32 articles that described 23 randomized and 4 non-randomized clinical trials. The interventions included individualized nutritional counseling (n = 14 articles), nutritional counseling plus exercise (n = 4), and nutritional counseling focused on increasing or reducing intake of specific nutrients (n = 9). Trials targeted head and neck (n = 12), pelvic cancers (n = 14), and/or breast (n = 5) cancers. Control groups had variable designs and included general nutrition education and intervention as needed. Studies recruited 120 ± 104 participants (range 26-468). Interventions tended to be feasible regarding retention and attendance at sessions, though feasibility metrics varied among different interventions. Most interventions were safe with no studies reporting adverse events attributable to dietary intervention. Individualized dietary counseling interventions tended to lead to between-group differences favoring the intervention group in regard to improved nutritional status, maintenance or attenuation of loss of body mass, improved quality of life, and reduced radiation-induced toxicities. Diets that encouraged/discouraged specific nutrients tended to recruit patients receiving radiation to the pelvic area and resulted in positive or neutral effects on gastrointestinal symptoms. In conclusion, nutritional interventions appear to be feasible, safe, and effective during radiotherapy for various symptom outcomes.

This study investigates the impact of neoadjuvant therapy (NT) on body composition and its correlation with long-term survival and other clinical outcomes in patients with advanced gastric cancer. We utilized Computed Tomography (CT) scans to measure body composition before and after NT, including Subcutaneous Adipose Tissue Index (SATI), Visceral Adipose Tissue Index (VATI), Skeletal Muscle Index (SMI), and Muscle Density (MA). We then analyzed the decrease in body composition in relation to tumor regression, inflammatory markers, nutritional scores, and long-term survival. Our findings reveal a negative correlation between the decrease in SATI and VATI after NT, and both tumor regression and nutritional score. Notably, patients who experienced a significant loss in SATI or VATI post-NT had shorter Recurrence-Free Survival (RFS) and Overall Survival (OS). Additionally, significant loss in SATI and VATI emerged as an independent risk factor for both RFS and OS. In conclusion, our study convincingly demonstrates that in patients with advanced gastric cancer, SATI and VATI decreases after NT and is negatively associated with tumor regression and nutritional score. A significant loss in SATI and VATI is a risk factor for shorter RFS and OS, thereby underscoring the importance of maintaining body composition during NT.

Currently, the combination of atezolizumab and bevacizumab (Atez/Bev) is recommended as the first-line therapy for patients with advanced hepatocellular carcinoma (HCC). However, there is a lack of research on the levels of nutrient elements in advanced HCC patients receiving Atez/Bev treatment. In this study, data from 35 patients with advanced HCC and 37 healthy individuals of similar age and sex were included. The levels of alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase were significantly increased in patients with HCC. These levels returned to the reference range after three rounds of Atez/Bev treatment. Additionally, the levels of blood urea nitrogen and creatinine (Cr) increased after Atez/Bev treatment. In HCC patients, the levels of calcium (Ca), iron (Fe), and copper (Cu) were significantly higher, while the levels of sodium (Na), magnesium (Mg), and zinc (Zn) were significantly lower compared to healthy individuals. These changes were reversed after Atez/Bev treatment. In conclusion, our findings indicate that treatment with Atez/Bev influences the levels of Ca, Fe, Cu, Na, Mg, and Zn in patients with HCC. The alterations in these elements caused by Atez/Bev treatment require mechanistic research in the future.

Sarcopenia is common in patients with head and neck cancer and is suggested to be associated with decreased survival. This study aimed to investigate the relationship between changes in skeletal muscle mass during alternating chemoradiotherapy (CRT) and the prognosis of patients with nasopharyngeal carcinoma (NPC). This retrospective study included 64 patients with NPC who had undergone alternating CRT at our institution between 2005 and 2022. The skeletal muscle mass index (SMI) was measured using pre- and post-treatment computed tomography. SMI decreased in 58 patients (90.6%), with a mean change of -6.1%. Using a cutoff value of -6.0% for SMI change, 32 patients (50.0%) were categorized into the SMI loss group. The SMI loss group had a significantly lower mean overall survival (OS) than the SMI maintenance group (122.6 vs. 153.0 months; p = 0.021). Multivariate analysis identified SMI loss and prognostic nutritional index (PNI) as independent predictors of poor OS (p < 0.05). They were used to construct the nomogram of OS. In conclusion, SMI loss during alternating CRT was identified as a poor prognostic factor. These findings suggest that preserving skeletal muscle mass during alternating CRT may improve the prognosis and merits further investigation.

Creatine has demosntrated protective effects against muscle dysfunction, but its potential protection against doxorubicin-induced cardio and skeletal muscle toxicity remains poorly understood. We aimed to investigate the protective effects of creatine supplementation against doxorubicin-induced cardio and skeletal muscle myotoxicity. This study analyzed twenty male C57BL/6J mice, divided into three groups: Control (C; n = 6), Dox (n = 7) which received weekly doxorubicin injections (16 mg/kg i.p. in 20 days) and DoxCr (n = 7) with both doxorubicin and creatine supplementation (4%). Doxorubicin administration induced skeletal muscle atrophy in extensor digitorum longus (EDL) (-28%) and soleus muscles (-17%), accompanied by a decline in muscle strength. This atrophic response was concomitant with increased oxidative stress and elevated levels of IL-6. Cardiotoxic effects of doxorubicin were marked by a 15% reduction in cardiac mass and a significant 21% decrease in cardiomyocyte diameter, alongside a substantial 58% rise in IL-6 levels. On the opposite creatine supplementation mitigated doxorubicin-induced oxidative stress (elevated MDA and IL-6, and reduced GSH/GSSG ratio) and prevented skeletal muscle atrophy in both the EDL and soleus muscles, while also enhancing muscle strength. However, protective effects were not observed in cardiac muscle. Creatine protects skeletal, but not cardiac muscle against doxorubicin-induced toxicity, atrophy and strength loss.

Background: Patients with esophageal cancer are prone to poor nutrition. Concurrent chemoradiation therapy (CCRT) may further influences body compositions including skeletal muscle (SM) and adipose tissue which are key indicators of nutritional status. This study aimed to evaluate whether body compositional change during CCRT could be a predictor of prognosis in esophageal cancer patients.

Methods: From 2006 to 2018, esophageal cancer patients who received CCRT as initial treatment were consecutively enrolled. We assessed body compositions, including subcutaneous fat (SCF), intramuscular fat (IMF), and SM mass by measuring the cross-sectional area (CSA) of the fourth thoracic vertebral body on computed tomography (CT) scan. The body compositional change was assessed by comparing baseline and post-CCRT CSA. The association of body compositions and their changes during CCRT with patient prognosis was analyzed.

Results: A total of 178 patients were enrolled with a mean baseline body mass index (BMI) of 22. After CCRT, there was a significant decrease in bodyweight (BW), SCF, IMF, and SM (P < 0.001). BMI and body compositions at baseline or post-CCRT were not significantly associated with patient prognosis. Patients with SCF loss during CCRT had significantly poorer CCRT response (OR 3.7, P < 0.001), shorter time to tumor progression (8.5 vs. 23.7 months, P = 0.011), and overall survival (13.7 vs. 25.9 months, P < 0.001) than patients with SCF gain/stable. IMF, SM, and BW change during CCRT did not correlate with CCRT response or survival. In multivariate Cox regression analysis, SCF change (HR 1.49, 95% CI: 1.03-2.14, P = 0.033) during CCRT was an independent predictor of survival after adjusting baseline BMI, cancer stage, treatment modality, and CCRT response.

Conclusions: During the course of CCRT, SCF change is more sensitive than weight in assessing the nutritional status of esophageal cancer patients. SCF loss during CCRT is associated with worse CCRT response and survival in esophageal cancer patients.