Chemotherapy is the cornerstone of the treatment of patients with non‐metastatic breast cancer; however, its toxicity may be limiting. It has been reported that some degree of toxicity is present in 98% of patients. To date, no predictors of this toxicity have been identified. Bioimpedance and Phase Angle (PA) are non‐invasive procedures to evaluate nutritional status. The aim of this study was to associate the PA with chemotherapy toxicity during (neo)adjuvant (neoCT) treatment of breast cancer.
172 patients were prospectively evaluated, 31 were excluded because they had metastatic disease or had received endocrine therapy. Only chemotherapy candidates were enrolled, patient selection criteria were PS 0‐1, adequate liver, hematologic and renal function tests. The chemotherapy regimen consisted in AC‐T at standard doses and schedules +/‐ cisplatin in triple-negative tumors. Toxicity was evaluated per NCI CTC v4.0. In all patients bioimpedance by SECA mBCA 514 and Inbody 720 were registered. Statistical analysis was done with SPSS v20.0.
141 were analyzed, median age was 50 years old, 53.2% of them received neoCT and 46.8% adjuvant CT. Regarding comorbid status, 10.6% had diabetes, 14.0% had hypertension, most of the patients were obese or over weight, median BMI was 27.7kg/m2 (13.79‐39.84 kg/m2), median waist circumference was 97.30cm (72‐135 kg/m2), overall metabolic syndrome per ATPIII criteria was found in 34.1% of all patients. 54.3% were diagnosed in early stage (I‐IIb), 24.2% were HER2‐positive, 46.8% were HR‐positive and 29.1% were triple negative. Any grade of toxicity was present in 98.6%, 9.9% required hospitalization and in 2.1% toxicity led to death, most common side effects were gastrointestinal 85.8%, fatigue 70.9%, peripheral neuropathy 50.4% and hematologic 48.9%. PA average was 4.8° (2.8‐6.26°). We found a correlation between PA and any grade of toxicity (p = 0.022). Patients with low PA had more G3-5 toxicity (p = 0.045). and more peripheral neuropathy (p = 0.045).
PA helps us to assess nutritional status and it seems to be useful as a toxicity predictor. However, external validation is necessary to confirm this benefit.
Clinical trial identification
Legal entity responsible for the study
Maria Tereza Nieto Coronel.
Has not received any funding.
All authors have declared no conflicts of interest.