Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 21, 2021; 27(19): 2366-2375
Published online May 21, 2021. doi: 10.3748/wjg.v27.i19.2366
Changes in the nutritional status of nine vitamins in patients with esophageal cancer during chemotherapy
Lan-Qing Liang, Ling-Ling Meng, Bo-Ning Cai, Ze-Ping Cui, Na Ma, Le-Hui Du, Wei Yu, Bao-Lin Qu, Sheng-Qiang Feng, Fang Liu
Lan-Qing Liang, Ling-Ling Meng, Bo-Ning Cai, Ze-Ping Cui, Na Ma, Le-Hui Du, Wei Yu, Bao-Lin Qu, Fang Liu, Department of Radiotherapy, Chinese PLA General Hospital, Beijing 100853, China
Sheng-Qiang Feng, Department of Health Service, The Guard Bureau of Joint Staff Department of Chinese PLA, Beijing 100017, China
Author contributions: Liang LQ and Meng LL contributed equally to this work; Liang LQ and Meng LL designed and performed the research and wrote the paper; Liu F designed the research and supervised the report; Cui ZP and Ma N designed the research and contributed to the analysis; Du LH, Yu W and Feng SQ provided clinical advice; Qu BL and Cai BN supervised the report.
Supported by Health Bureau of the Department of Logistics and Security of the Central Military Commission of China, No. 17BJZ47.
Institutional review board statement: The study was reviewed and approved by the Medical Ethics Committee of the General Hospital of the Chinese People’s Liberation Army, No. S2019-198-02.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All authors hereby declare that there is no personal conflict of interest that may cause impact or bias to the results of this study. All authors read and approved the final manuscript.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fang Liu, MD, Associate Chief Physician, Department of Radiotherapy, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China. liufangfsq@163.com
Received: February 2, 2021
Peer-review started: February 2, 2021
First decision: March 6, 2021
Revised: March 18, 2021
Accepted: April 13, 2021
Article in press: April 13, 2021
Published online: May 21, 2021
Processing time: 100 Days and 0.4 Hours
Abstract
BACKGROUND

Many studies have investigated the relationships between vitamins and esophageal cancer (EC). Most of these studies focused on the roles of vitamins in the prevention and treatment of EC, and few studies have examined the changes in vitamin nutritional status and their influencing factors before and after chemotherapy for EC. Chemotherapy may have a considerable effect on EC patients’ vitamin levels and hematological indicators.

AIM

To research the nutritional status of multiple vitamins in EC patients during chemotherapy and to assess its clinical significance.

METHODS

EC patients admitted to our center from July 2017 to September 2020 were enrolled in this study. Serum concentrations of nine vitamins (A, D, E, B9, B12, B1, C, B2 and B6), hemoglobin, total protein, albumin, blood calcium, blood phosphorus concentrations and body mass index (BMI) were measured in all EC patients. The changes in nine vitamins, hematological indicators and BMI were compared before and after two cycles of chemotherapy. The possible influential factors were analyzed.

RESULTS

In total, 203 EC patients receiving chemotherapy were enrolled in this study. Varying degrees of vitamin A, D, C and B2 deficiency and weight loss were found in these patients, and the proportions of vitamin B2 and vitamin C deficiencies increased significantly after chemotherapy (both P < 0.05). Serum concentrations of vitamins A, C, B2 and B6 and BMI before and after chemotherapy were statistically significant (all P < 0.05). Multivariate analysis showed that vitamin A levels significantly differed between male and female EC patients, whereas vitamin D concentration significantly differed in EC patients in different stages (all P < 0.05). Correlations were observed between the changes in serum concentrations of vitamin A and C before and after two cycles chemotherapy and the change in BMI (P < 0.05). Hemoglobin, total protein, serum albumin and blood calcium concentrations significantly decreased in EC patients after chemotherapy (all P < 0.05), while the blood phosphorus level significantly increased after chemotherapy (P < 0.05). Using the difference in vitamin concentrations as the independent variables and the difference in BMI as the dependent variable, logistic regression analysis revealed statistically significant differences for vitamin A, vitamin D and vitamin C (F = 5.082, P = 0.002).

CONCLUSION

Vitamin A, D, C and B2 were mainly deficient in patients with EC during chemotherapy. Multivitamin supplementation may help to improve the nutritional status, chemotherapy tolerance and efficacy.

Keywords: Esophageal cancer; Chemotherapy; Vitamins; Nutritional status; Body mass index

Core Tip: This retrospective study investigated the changes in serum vitamins before and after chemotherapy for esophageal cancer. Vitamin deficiencies are common in esophageal cancer patients during chemotherapy and may be associated with the change in body mass index. There were correlations between the changes in vitamin A and C concentrations and the change in body mass index during chemotherapy. Vitamin A level after chemotherapy showed a significant difference between males and females, and the vitamin D level after chemotherapy showed a significant difference among different stages. Vitamin supplementation may reduce the adverse effects of chemotherapy and improve the nutritional status.