Changes in Body Weight, Body Composition, Phase Angle, and Resting Metabolic Rate in Male Patients with Stage IV Non-Small-Cell Lung Cancer Undergoing Therapy

Abstract

Background and Objectives: Cancer treatments can adversely influence body weight status, body composition, phase angle (PhA), and resting metabolic rate (RMR), which could possibly affect disease course. Τhe aim was to assess differences in body composition, PhA, RMR, and related parameters in non-small-cell lung cancer (NSCLC) patients after treatment. Methods: The sample consisted of 82 NSCLC (stage IV) male patients (chemotherapy (C) 15.7%; immunotherapy (I) 13.3%; C + I 25.3%; (C) + radiotherapy (R) 22.9 %; and other 15.5%). Body weight and body composition, PhA, RMR, oxygen consumption (VO2), ventilation rate, and diet were assessed at baseline and at 3 months after initiation of therapy. Results: Reductions in PhA, RMR, VO2, ventilation rate, and intracellular water were observed at follow up. Weight loss was evident for 45% of patients who also had a reduction in lean body mass. In the group under C, lean mass was reduced at follow up (55.3 ± 11.53 vs. 52.4 ± 12.6, p = 0.04) without significant weight changes. In subjects with a low adherence to the Mediterranean diet (MedDietScore < 30), RMR (1940 ± 485 vs. 1730 ± 338 Kcal, p = 0.001), VO2 (277.1 ± 70.2 vs. 247 ± 49.1 mL/min, p = 0.001), and ventilation rate (10.1 ± 2.28 vs. 9. ± 2 2.2 L/min, p = 0.03) were significantly reduced. The changes in body weight were positively related to % of change in fat mass (rho = 0.322, p = 0.003) and absolute lean mass change (rho = 0.534, p < 0.001) and negatively associated with % of change in total body water (rho = −0.314, p = 0.004) (Spearman correlation coefficients). Conclusions: In conclusion, cancer therapy related to reductions in PhA and RMR, while lean mass reduction may be related to the type of treatment. Our results emphasize the importance of a more holistic nutritional and body composition assessment beyond body weight, to better address patients’ needs in clinical practice.

Relation of Mean Platelet Volume (MPV) with Cancer: A Systematic Review with a Focus on Disease Outcome on Twelve Types of Cancer

“…Moreover, several variables that influence MPV, such as genetic polymorphisms, body composition, and diet, were not assessed, and these may affect both cancer prognosis [ 129 ] and platelet secretory molecules [ 130 , 131 , 132 ]. In addition, usual treatments may also induce changes in biological parameters [ 133 ]. Last but not least, cancer patients often take vitamins and oral nutritional supplements to cover their nutritional needs, which most often contain fat to increase caloric supply [ 134 ].…”

Bioelectrical impedance analysis—derived phase angle (PhA) in lung cancer patients: a systematic review

“…In Detopoulou et al [ 40 ] were found significant correlations between PhA and FFM (rho = 0.247; p = 0.02), but no significant correlation for waist and hip circumference (cm), waist-hip ratio, body fat (%), BCM (Kg), total body water (TBW), extra-cellular and intra-cellular water (ECW, ICW). In the other study, Spearman’s correlation shows no significance between PhA, anthropometric and BC variables [ 41 ]. In Wei Ji et al [ 36 ], in addition to PhA, other variables were also examined, such as appendicular skeletal muscle mass (ASMM), BMI and skeletal muscle mass index (SMI).…”

“…Three studies included patients not undergoing CHT, RT and without specific treatment information [ 37 , 39 , 45 ] while newly diagnosed patients and/or patients with ongoing therapies were evaluated in remaining studies [ 34 , 36 , 38 , 42 ]. Suzuki et al [ 43 ] evaluated LC patients after surgery while patients were evaluated after cancer treatment in two studies [ 40 , 41 ]. Castanho et al [ 44 ] evaluated patients after surgery and after cancer treatment (CHT, RT).…”

“…The main associations identified in selected studies, between PhA and different variables, are shown in Table 2 . In seven studies parameters related to BC have been evaluated [ 36 , 39 – 41 , 43 , 44 ]. Castanho et al [ 44 ] correlates PhA with arm circumference and weight loss over time.…”