Meme Kanseri Hastalarının Kemoterapi Sürecinde Beslenme Durumu, Bazı Biyokimyasal Parametreler ve Yaşam Kalitesinin Değerlendirilmesi.

Abstract

Şahin Kaya A., Evaluation of Nutritional Status, Some Biochemical Parameters and Quality of Life in Breast Cancer Patients During Chemotherapy. Hacettepe University Graduate School of Health Sciences, Nutrition and Dietetics Program PhD Thesis, Ankara, 2019. The aim of this study was to evaluate the nutritional status, biochemical parameters and quality of life of breast cancer patients in different stages of chemotherapy and to determine these parameter’s possible relationships. 50 women aged 30-65 years who were admitted to Medical Oncology Department of Health Research and Application Center of Namık Kemal University, Tekirdağ, were included in this study. At the beginning, middle and end of the chemotherapy; a questionnaire was used to evaluate general characteristics and health status, food consumption frequency and quality of life. At the same time, height and body weight, body mass index (BMI), waist and hip circumference were recorded. Blood samples were taken from individuals and oxidative stress parameters (total antioxidant status-TAS, total oxidant status-TOS, nitric oxide-NO, superoxide dismutase-SOD, glutathione peroxidase-GPx, 8-hydroxy-2'-deoxyguanosine) were analyzed by ELISA method. Catalase and malondialdehyde (MDA) were analyzed by manual method. Body weight, BMI, waist circumference measurements and hip circumference measurements were significantly different between different chemotherapy stages (p<0,001). These measurements decreased in the middle compared to the beginning of chemotherapy and increased at the last stage, approaching the initial measurements. As a result of multiple comparisons between courses, the difference between the beginning and the middle of the treatment and the difference between the middle and the end of treatment were significant (p<0,001). In terms of energy and macronutrient intake levels, the decrease in the intake levels in the middle of treatment was significant (p<0,001). Energy, carbohydrate, protein, fat and fiber intake levels increased significantly at the end of the treatment (p<0,001). Micro nutrients; retinol, vitamin E, vitamin B, folate, sodium, potassium, calcium, magnesium, phosphorus, iron, zinc, manganese and copper intake levels decreased in the middle of treatment and eventually increased again. This change in the middle and end of the treatment compared to the beginning of the treatment was significant (p<0,001). In the quality of life assessment, the decrease in the middle of the treatment and the increase in the end of the treatment were significant in functional and general health scores (p<0,001). The symptom score increased in the middle of treatment and significantly decreased in the end (p<0,001). TOS and GPx values decreased in the middle of treatment and continued to decrease in the end (p=0,02 and p=0,007, respectively). Changes in other oxidative parameters were not significantly different (p> 0,05). A significant and inverse correlation was found between body weight and TAS and TOS at the beginning of chemotherapy (r=-0,384 p=0,006 and r=-0,373 p=0,008, respectively). At the beginning of chemotherapy, there was no significant correlation between macro and micro nutrient uptake levels and oxidative parameters (p>0,05). There was a significant and inverse correlation between monounsaturated fatty acid intake and MDA level in the middle of chemotherapy (r=-0,359 and p=0,010). At the beginning of chemotherapy, there was an inverse correlation between symptom score and vitamin C intake level, functional score at mid-treatment, and general health score and vitamin E intake level (r=0,345 and r=0,469, respectively). According to the results of this study, anthropometric measurements, oxidative parameters and quality of life of individuals change according to nutritional status during chemotherapy. For this reason, individuals should be monitored from the moment of diagnosis in order to establish an adequate and balanced nutrition pattern and assessment of nutritional status should be continued during treatment. Furthermore, there is a need for more research and application on adequate and balanced nutrition during and after the treatment of breast cancer.