Gasto energético de repouso de pacientes com câncer de esôfago, estômago, cólon e reto

Abstract

Malnutrition in cancer patients is frequently reported, multifactorial and impacts on prognosis and quality of life. Changes in resting energy expenditure (REE) seem to be one of the causes of nutritional depletion. Thus, assessing possible changes in energy expenditure is essential for proper development of nutritional strategies. The aim of this study was to evaluate potential abnormalities in REE of patients with cancer of the digestive tract. Twenty patients diagnosed with esophageal (n = 3), stomach (n = 9), colon and rectum (n = 8) cancer were evaluated for REE and nutritional status before starting cancer treatment. Twenty healthy subjects were recruited as matched controls. Indirect calorimetry (IC) was used to measure the REE of both groups. Furthermore, we compared the total energy expenditure (TEE) obtained by IC corrected by a activity factor with usual equations. We used the Mann Whitney, paired t and paired Mann Whitney tests to compare means and medians and, the Bland-Altman to assess agreement. The significance was set at p <0.05. Severe weight loss occurred in 45% of patients and malnutrition was diagnosed in 80%. There was no significant difference in REE assessing different aspects of cancer patients as well as the nutritional status of patients. The REE of patients and controls was similar, with a median 1,274.5 Kcal (1,002.9 to 2,174.9) between cases and 1,445.5 kcal (1,114.5 to 1,762.6) among controls. TEE estimated by the pocket equation (30 Kcal/Kg), was similar to that found by corrected IC, suggesting that the first may routinely be used to determine energy needs. However, it is stressed that nutritional monitoring is essential to assess the effectiveness of the proposed treatment and better outcome of the disease.