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Clin Nutr. 2017 Dec;36(6):1473-1482. doi: 10.1016/j.clnu.2016.12.003. Epub 2016 Dec 18.

Association between cachexia, chemotherapy and outcomes in older cancer patients: A systematic review.

Author information

1
AP-HP, Henri-Mondor Teaching Hospital, Department of Geriatrics, Geriatric Oncology Clinic, F-94010 Créteil, France; Expert Group on Geriatric Oncology, Société Francophone d'OncoGériatrie (SoFOG), Rheims, France. Electronic address: philippe.caillet@aphp.fr.
2
Expert Group on Geriatric Oncology, Société Francophone d'OncoGériatrie (SoFOG), Rheims, France; Pôle de Gériatrie, CHU La Milétrie, Poitiers, France. Electronic address: evelyne.liuu@chu-poitiers.fr.
3
Department of Geriatrics, Hôpital Bichat, Paris, France; Expert Group on Nutrition and Geriatrics (GEGN), Société Française de Gériatrie et Gérontologie (SFGG), Paris, France. Electronic address: agathe.raynaud-simon@aphp.fr.
4
Expert Group on Nutrition and Geriatrics (GEGN), Société Française de Gériatrie et Gérontologie (SFGG), Paris, France; Department of Geriatric Medicine, CHU Lyon Groupement Hospitalier Sud, 69495 Pierre-Bénite Cedex, France. Electronic address: marc.bonnefoy@chu-lyon.fr.
5
Expert Group on Geriatric Oncology, Société Francophone d'OncoGériatrie (SoFOG), Rheims, France; Expert Group on Nutrition and Geriatrics (GEGN), Société Française de Gériatrie et Gérontologie (SFGG), Paris, France; Department of Geriatric Medicine, CHU Nice, University of Nice Sophia Antipolis, Nice, France. Electronic address: guerin.o@chu-nice.fr.
6
Expert Group on Nutrition and Geriatrics (GEGN), Société Française de Gériatrie et Gérontologie (SFGG), Paris, France; Department of Geriatric Medicine, Hôpital Bellier, CHU Nantes, France. Electronic address: gilles.berrut@chu-nantes.fr.
7
Expert Group on Nutrition and Geriatrics (GEGN), Société Française de Gériatrie et Gérontologie (SFGG), Paris, France; Department of Geriatrics, CHU Clermont-Ferrand, UPRES AME 2P, University of Clermont-Ferrand, Clermont-Ferrand, France. Electronic address: lesourd.bruno@orange.fr.
8
Expert Group on Nutrition and Geriatrics (GEGN), Société Française de Gériatrie et Gérontologie (SFGG), Paris, France; Centre de Gérontologie, Clinique Antonin Balmes, CHU de Montpellier, University I Montpellier, Montpellier, France. Electronic address: claudejeandel@yahoo.fr.
9
Expert Group on Nutrition and Geriatrics (GEGN), Société Française de Gériatrie et Gérontologie (SFGG), Paris, France. Electronic address: monique.ferry@club-internet.fr.
10
Expert Group on Nutrition and Geriatrics (GEGN), Société Française de Gériatrie et Gérontologie (SFGG), Paris, France; Gerontopôle, Toulouse University Hospital, Toulouse, France. Electronic address: rolland.y@chu-toulouse.fr.
11
AP-HP, Henri-Mondor Teaching Hospital, Department of Geriatrics, Geriatric Oncology Clinic, F-94010 Créteil, France; Expert Group on Geriatric Oncology, Société Francophone d'OncoGériatrie (SoFOG), Rheims, France; Expert Group on Nutrition and Geriatrics (GEGN), Société Française de Gériatrie et Gérontologie (SFGG), Paris, France. Electronic address: elena.paillaud@aphp.fr.

Abstract

BACKGROUND & AIMS:

The aims of this systematic review were (i) to determine the prevalence of malnutrition and cachexia in older cancer patients in a chemotherapy setting, and (ii) to report the chemotherapy-related causes of malnutrition and (iii) the consequences of malnutrition on the outcomes of these patients.

METHODS:

We searched MEDLINE for articles published in English or French between 2005 and 2016 and which reported retrospective or prospective, observational or interventional studies of the prevalence of malnutrition and its consequences in patients 65 years or older with solid tumors and chemotherapy-related causes of malnutrition.

RESULTS AND CONCLUSION:

Malnutrition is prevalent up to 83% in older patients with cancer scheduled to receive chemotherapy. One third or more of patients were malnourished before receiving chemotherapy. A weight loss of 10% or more during the past three or six months was reported in 8%-40% of cancer patients, while a body mass index <21 kg/m2 was found in 10.7%-23%. Malnutrition was more prevalent in digestive (28%-75%) than in non-digestive cancers (8%-46.9%), and also in metastatic cancers (64%-76.5%). During the course of chemotherapy, weight loss was observed in 40%-91.6% of patients, depending on cancer location. The most frequently reported chemotherapy-related digestive symptoms likely to impair nutritional status were dry mouth, nausea, stomach pain, diarrhea and constipation. Low Mini-Nutritional-Assessment score was an independent predictor of early discontinuation of chemotherapy and increased the risk of mortality.

KEYWORDS:

Cachexia; Cancer; Chemotherapy; Malnutrition; Older adults

PMID:
28017447
DOI:
10.1016/j.clnu.2016.12.003
[Indexed for MEDLINE]

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