Endocrine Abstracts

Introduction: Malnutrition is a common issue observed in patients undergoing treatment for cancer. It stems from various factors and poses a significant challenge in the effective care of these individuals, adding complexity to their overall management. The aim of our study was to determine the prevalence of undernutrition and risk of undernutrition in women with breast cancer and its effect on chemotherapy digestive tolerance.

Methodology: This was a cross-sectional, descriptive study conducted over a 6-month period in patients with cancer patients undergoing chemotherapy. The risk of malnutrition was assessed using the Malnutrition Universal Screening Tool (MUST score). The diagnosis of undernutrition was made according to the criteria of the French National Authority for Health. A BMI < 18.5 kg/m²;, weight loss >10% in 6 months, grip strength <16 kg and/or fat-free mass index <15 kg/m²; were the phenotypic criteria on which the study was based. The digestive effects studied were vomiting, diarrhoea and constipation. The tolerance was assessed according to WHO grades ranging from 0 to 5. High grades 3 and 4 signified toxic grades.

Results: During this period 107 patients were recorded. The mean age was 52.56±9.75 years. The mean BMI was 29.85±5.72 kg/m²;. According to the MUST score, 10% was classified as being at high risk of malnutrition and 31% were at moderate risk. A BMI <18.5 kg/m² was noted for only 2 patients. On the other hand, weight loss, reduced grip strength and reduced muscle mass were more frequent, with percentages of 12%, 31% and 13.1% respectively. Forty-one percent of patients were finally diagnosed as undernourished. The most marked digestive effects were transit disorders found in 80% of cases followed by nausea (70%) and vomiting (63%). They were of high grade in a third of cases. In multivariate analysis, BMI was not associated with digestive signs. However, significant weight loss and undernutrition were identified as risk factors associated with the severity of digestive effects. Undernutrition was significantly associated with the severity of vomiting (OR=17.5) and diarrhoea (OR= 1.06). In addition, the MUST score was linearly associated with high grades of all digestive toxicities.

Conclusion: There is a close relationship between undernutrition and digestive toxicity, justifying early nutritional management in order to improve the tolerance and efficacy of chemotherapy.