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Open AccessArticle

Impact of Clinical Markers of Nutritional Status and Feeding Jejunostomy Use on Outcomes in Esophageal Cancer Patients Undergoing Neoadjuvant Chemoradiotherapy

1
Fox Chase Cancer Center, Department of Hematology/Oncology, Philadelphia, PA 19111-2497, USA
2
Fox Chase Cancer Center, Department of Radiation Oncology, Philadelphia, PA 19111-2497, USA
3
Biostatistics, Fox Chase Cancer Center, Philadelphia, PA 19111-2497, USA
*
Author to whom correspondence should be addressed.
Nutrients 2020, 12(10), 3177; https://doi.org/10.3390/nu12103177
Received: 28 August 2020 / Revised: 7 October 2020 / Accepted: 15 October 2020 / Published: 17 October 2020
(This article belongs to the Special Issue Clinical Nutrition for Cancer Patients)
Background: Patients with esophageal cancer (EC) have high rates of malnutrition due to tumor location and treatment-related toxicity. Various strategies are used to improve nutritional status in patients with EC including oral and enteral support. Methods: We conducted a retrospective analysis to determine the impact of malnutrition and prophylactic feeding jejunostomy tube (FJT) placement on toxicity and outcomes in patients with localized EC who were treated with neoadjuvant chemoradiation therapy (nCRT) followed by esophagectomy. Results: We identified 125 patients who were treated with nCRT between 2002 and 2014. Weight loss and hypoalbuminemia occurred frequently during nCRT and were associated with multiple adverse toxicity outcomes including hematologic toxicity, nonhematologic toxicity, grade ≥3 toxicity, and hospitalizations. After adjusting for relevant covariates including the specific nCRT chemotherapy regimen received and the onset of toxicity, there were no significant associations between hypoalbuminemia, weight loss, or FJT placement and relapse-free survival (RFS) or overall survival (OS). FJT placement was associated with less weight loss during nCRT (p = 0.003) but was not associated with reduced toxicity or improved survival. Conclusions: Weight and albumin loss during nCRT for EC are important factors relating to treatment toxicity but not RFS or OS. While pretreatment FJT placement may reduce weight loss, it may not impact treatment tolerance or survival. View Full-Text
Keywords: nutrition; esophageal cancer; neoadjuvant chemoradiation; enteral nutrition nutrition; esophageal cancer; neoadjuvant chemoradiation; enteral nutrition
MDPI and ACS Style

Jain, R.; Shaikh, T.; Yee, J.-L.; Au, C.; Denlinger, C.S.; Handorf, E.; Meyer, J.E.; Dotan, E. Impact of Clinical Markers of Nutritional Status and Feeding Jejunostomy Use on Outcomes in Esophageal Cancer Patients Undergoing Neoadjuvant Chemoradiotherapy. Nutrients 2020, 12, 3177.

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