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J Gastrointest Cancer. 2018 Jul 30. doi: 10.1007/s12029-018-0147-7. [Epub ahead of print]

Vitamin D Levels in Patients with Colorectal Cancer Before and After Treatment Initiation.

Author information

1
UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA.
2
Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.
3
Department of Medicine, Division of Hematology/Oncology, University of California, San Francisco, CA, USA.
4
Department of Colorectal Surgery, University of California, San Francisco, CA, USA.
5
UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA. katherine.vanloon@ucsf.edu.
6
Department of Medicine, Division of Hematology/Oncology, University of California, San Francisco, CA, USA. katherine.vanloon@ucsf.edu.

Abstract

PURPOSE:

We aimed to described 25-hydroxyvitamin D [25(OH)D] levels in newly diagnosed colorectal cancer (CRC) patients and to re-evaluate levels after chemotherapy.

METHODS:

Permanent residents of the San Francisco Bay Area with a new CRC diagnosis of any stage were recruited prior to any non-surgical therapy. Serum 25(OH)D levels were measured at time of diagnosis and 6-month follow-up. Supplement use was not restricted. The primary endpoint was the frequency of vitamin D deficiency in patients with newly diagnosed CRC of all stages. The Kruskal-Wallis and Spearman correlation tests were used to evaluate associations of patient characteristics with 25(OH)D levels.

RESULTS:

Median 25(OH)D level at baseline was 27.0 ng/mL (range 7.2, 59.0); 65% of patients had insufficient levels (25(OH)D < 30 ng/mL) (n = 94). Race, disease stage, multivitamin use, vitamin D supplementation, and county of residence were associated with baseline 25(OH)D levels (P < 0.05). The median change in 25(OH)D from baseline to 6 months was - 0.7 ng/mL [- 19.4, 51.7] for patients treated with chemotherapy (n = 58) and 1.6 ng/mL [- 6.4, 33.2] for patients who did not receive chemotherapy (n = 19) (P = 0.26). For patients who received vitamin D supplementation during chemotherapy, the median 25(OH)D change was 8.3 ng/mL [- 7.6, 51.7] versus - 1.6 [- 19.4, 24.3] for chemotherapy patients who did not take vitamin D supplements (P = 0.02).

CONCLUSION:

Among patients with a new diagnosis of CRC, most patients were found to have 25(OH)D levels consistent with either deficiency or insufficiency. In the subset of patients who received chemotherapy and took a vitamin D supplement, serum 25(OH)D levels increased, suggesting that vitamin D repletion is a feasible intervention during chemotherapy.

KEYWORDS:

Chemotherapy; Colorectal cancer; Geographic variation; Supplementation; Vitamin D

PMID:
30058032
DOI:
10.1007/s12029-018-0147-7

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