Impact of Nutritional Status on Chemotherapy Related Digestive Toxicity in Women With Breast Cancer

Abstract

Introduction: Any alteration in nutritional status can compromise the progression of breast cancer, as well as the tolerance and efficacy of chemotherapy. The aims of our study were to assess the nutritional status of breast cancer patients treated with chemotherapy and to identify nutritional factors that may exacerbate chemo-induced digestive toxicity. Methods: This descriptive cross-sectional study was conducted within the medical oncology department of the National Institute of Salah Azaiez. A Mediterranean Diet Score (MDS) was used to evaluate the level of adherence to the Mediterranean Diet. Nutritional status was assessed using 2 methods; body composition evaluation utilising the TANITA BC 601 impedance metre and High authority of health (HAS) criteria of malnutrition. Digestive effects were assessed with World Health Organization (WHO) grades ranging from 0 to 4. High grades 3 and 4 signified toxic grades. Results: We enrolled 107 adult women diagnosed with breast cancer undergoing the same chemotherapy protocol. The participants had an average age of 52.56 ± 9.75 years and an average BMI of 29.85 ± 5.72 kg/m 2 with 78.5% classified as overweight. Malnutrition was observed in 41% of patients, while sarcopenia was present in 12%. Chemotherapy-related adverse effects were predominantly constipation (80%), diarrhea (73%), nausea (70%) and vomiting (63.4%) with one-third experiencing high-grade toxicity. Strong adherence to Mediterranean Diet was observed in 48.6% of cases and higher MDS scores were inversely correlated with the severity of nausea ( P = .01) and constipation ( P = .02). Malnutrition was significantly associated with all digestive toxicities except with constipation. Sarcopenia was associated only with vomiting ( P = .005). Conclusion: There is a relationship between nutritional status and digestive toxicity, justifying early nutritional treatment to improve the tolerance and efficacy of chemotherapy.