engleski

Body composition of breast cancer patients treated with adjuvant chemotherapy and its influence on quality of life

Body composition has been studied relatively recently as part of oncology trials in different types of tumours in the context of the metabolism of different anticancer drugs, the assessment of response to treat- ment and its toxicity, and consequently the overall prognosis of the disease depending on the proportion of each body component. There are numerous studies that clearly define the impact of chemotherapy and its side effects on quality of life of breast cancer patients, however there have been few studies that have anal- ysed the impact of body composition on chemotherapy tolerance as well as on the quality of life of premeno- pausal patients in the course of cytotoxic treatment. The study was performed on a consecutive sample of patients treated with neoadjuvant or adjuvant chemotherapy for early- stage breast cancer at the daily hospi- tal of the Department of Medical Oncology of University hospital for Tumors in Zagreb between December 2018. and April 2019. All patients were premenopausal (study allowed inclusion of patients who have had their last menstrual cycle within one year before the start of treatment). All patients received four cycles of AC chemotherapy (doxorubicin + cyclophosphamide) every three weeks, before or after the surgery. The total dose of doxorubicin administered was 240 mg/m2 and cyclophosphamide 2400 mg/m2 for all patients. During the each visit patients filled standardized quality od life questionnaires (EORTC QLQ-C30 and QLQ- B23) and patient’s body composition was estimated using Tanita BC-420MA analyzer. The data were pre- sented as averages with standard deviations for numeric data, or numbers and percentages for categorical data. The testing was performed with Pearson’s correlation coefficient. All analyses were performed in R, with significance set at P<0.05. The study included 68 patients with median age of 46, 6 years (range 29- 55 years). Analysis of the results of body composition measurements in correlation with QoL showed the impact of body composition on certain QoL subdomains during treatment. At the beginning of treatment, the most pronounced was the connection between body composition and physical and sexual functioning and hair loss. In the second cycle, significant quality-of- life result included financial problems, while in subsequent treatment cycles other variables begin to significantly affect subdomaines of quality of life, in particular fatigue and diarrhoea. At the beginning of the study, at the first measurement, patients with higher body mass and increased visceral fat index have shown worse physical performance than other patients. During the entire study, sexual functioning in patients with higher visceral fat index was significantly reduced. In a later course of the study, it was shown that body composition significantly influenced the occurrence of fatigue during treatment, that is, that patients with a higher percentage of body fat and visceral fat index were significantly more tired than patients who had a higher percentage of muscle mass. In conclusion, our research showed significant correlation between some components of body composition and QoL subdo- mains in premenopausal patients with early breast cancer treated with chemotherapy. This kind of informa- tion can be used in planning interventions for specific subgroup of patients which can bring an improvement in the patient’s well-being during chemotherapy, improve patient’s adherence to therapy and thus indirectly influence prognosis of the disease. This research has some limitations including unrandomized design, which could have led to significant deviation of the results, small sample size and most importantly indi- vidual characteristics of each patient which may significantly affect the studied parameters.

body composition, bioelectric impedance, breast cancer, adjuvant chemotherapy, quality of life

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