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Journal of the American College of Nutrition, Vol. 23, No. 2, 102-107 (2004)
Published by the American College of Nutrition

Original Research

Long-Term Nutritional and Digestive Consequences of Pelvic Radiation

María Pía de la Maza, MD, MSc, Gloria Maria Agudelo, MSc, Talía Yudin, MD, Vivian Gattás, RD, Gladys Barrera, RN, Daniel Bunout, MD and Sandra Hirsch, MD, MSc

Institute of Nutrition and Food Technology (INTA)—University of Chile (M.P.d.l.M., G.M.A., V.G., G.B., D.B., S.H.)
Arturo López-Pérez Foundation (T.Y.), Santiago, CHILE

Address correspondence to: M. Pía de la Maza MD, MSc, INTA, University of Chile, Macul 5540, PO Box: 138-11 Santiago, CHILE. E-mail: mpmaza{at}uec.inta.uchile.cl

Objective: To study long-term changes in nutritional status and gastrointestinal (GI) functions of 15 women previously treated with radiotherapy for gynecological cancer. Two years prior to this research, these patients had been assessed twice: before external radiotherapy and 5 weeks later, at the completion of the external dose (45–50 Gy).

Methods: Each patient was given complete clinical evaluation, consisting of dietary, physical activity and digestive symptoms questionnaires. Blood was drawn for routine clinical laboratory tests (hemoglobin, white blood cell count, creatinine, lipoproteins, glucose, total proteins, albumin, and C reactive protein). Body composition was assessed by classical anthropometric indicators and double beam X-ray absorptiometry (DEXA), while muscle strength was measured through a hand dynamometer. Resting energy expenditure (REE), obtained by indirect calorimetry, was subtracted from energy ingestion, derived from dietary records, to calculate energy balance.

Results: This third evaluation included fifteen patients. A significant increase in body mass index (BMI), % body fat and waist circumference were observed in comparison to earlier evaluations. The lean compartment decreased significantly, and REE descended in parallel. Meanwhile, total energy, fat and protein intake increased, compared to previous measurements. The changes in bowel habits observed during radiotherapy persisted at this third evaluation, with the exception of diarrhea, which was less reported. Abdominal bloating and rectal symptoms were the most prevalent complaints.

Conclusions: After radiation treatment for gynecological cancer, patients gained more body fat than expected in Chilean women around menopause. In spite of high protein ingestion, the loss of fat-free mass observed during radiation treatment was not recovered along with weight increase. This is probably associated with infrequent physical activity, both during and after treatment, and hyperphagia.

Key words: fat free mass, weight gain, body composition, radiotherapy, cancer

Abbreviations: DEXA = double beam X-ray absortiometry • REE = resting energy expenditure • TEE = total energy expenditure • BMI = body mass index • RE = radiation enteritis • ICRT = intracavitary radiotherapy • FFM = fat free mass • GI = gastrointestinal • RDA = recommended dietary allowances






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Copyright © 2004 by the American College of Nutrition.