Changes in Nutritional Status in Breast Cancer Patients Receiving Neoadjuvant Chemotherapy with the FEC–DOC Regimen

Abstract

Abstract

The purpose of this study was to demonstrate changes in the nutritional status of patients receiving neoadjuvant chemotherapy for breast cancer. We analyzed data indicative of nutritional status in the medical records of 50 breast cancer patients who received initial neoadjuvant chemotherapy between 2004 and 2007. The mean age of all patients were 48.7 (SD±9.0) years. Thirty one patients (62%) were allocated to Regimen I to start with docetaxel (DOC) followed by fluorouracil, epirubicin and cyclophosphamide (FEC). Nineteen patients (38%) were allocated to Regimen II starting with FEC first followed by DOC. Analysis showed that body mass index (BMI) was significantly increased after chemotherapy in all patients. Two-way analysis of variance showed that there were interactions among body weight, serum albumin and serum total protein, and that the pattern of changes in these parameters was different depending on the regimen. In both the Regimen I and Regimen II groups, significant reductions in serum total protein and serum albumin were observed after the first half of chemotherapy. However, in the Regimen I group, both parameters tended to improve, with a significant increase after the latter half of chemotherapy. In the Regimen II group, significant decreases in serum albumin and serum total protein, and a significant increase in body weight, were seen after the latter half of chemotherapy, so the weight increase might be caused by edema or fluid retention. Serum total cholesterol was significantly increased in both groups before and after chemotherapy. These findings suggested the need not only for guidance based on symptoms to date regarding reductions in the amount of food eaten, but also specific dietary and lifestyle advice about avoiding excessive food intake and preventing the development of edema.