Nutritional Assessment of Cancer Patients during Chemotherapy in Iran University of Medical Sciences Affiliated Hospitals, 2006-2007

Cancer associated malnutrition and depletion of nutritional reserves can lead to an increased risk of morbidity, reduced response to anticancer therapies and shorter survival in patients with cancer. The aim of this study was to assess the nutritional status of cancer patients during chemotherapy in hospitals affiliated to Iran University of Medical Sciences. In this longitudinal study 71 adult patients with different kinds of malignancies were selected through a stratified sampling method from Hazrat-e-Rasool Akram and Firoozgar hospitals. Nutritional status was evaluated by anthropometric indices (BMI, MAC, AMA, and TSF), biochemical parameters (Albumin, Total Protein), nutritional intake (24hours-Food Recall Questionnaire and 3days-Food Record) and Ottery’s PG-SGA questionnaire at the beginning, middle and end of chemotherapy period. Data were analyzed by Repeated Measure ANOVA, Wilcoxon and Kruskal-Wallis tests of SPSS V.12 software. A nonsignificant increasing trend was observed for the anthropometric and biochemical data and a nonsignificant decreasing trend was observed in macronutrients and energy consumption of 50 patients who successfully finished the treatment duration. Twenty one patients who expired during the treatment period had a significant decreasing trend for BMI and MAC (p=0.01 and p=0.02, respectively).The frequency of malnutrition varied from 0 to 100% according to different indices that used to identify the nutritional status. According to the Ottery’s PG-SGA questionnaire, 80% of the survived cases and 100% of the deceased patients required nutritional intervention. Our results demonstrate that the highest rate of malnutrition prevailed among patients who died during the treatment period had stage IV of the disease, Malignancy with Unknown Origin (MUO), upper GI and/or lung cancers. The frequency of malnutrition depends on stage and kind of malignancy and the methods used to assess the patients. Appropriate and early nutritional assessment is critical after the diagnosis of cancer and during anticancer treatments with the aim of using proper nutritional recommendations/interventions for cancer patients.