Nutritional Intervention Contributes to the Improvement of Symptoms Related to Quality of Life in Breast Cancer Patients Undergoing Neoadjuvant Chemotherapy: A Randomized Clinical Trial

Abstract

During breast cancer treatment, worsening quality of life (QoL) and the presence of toxicities are common, but healthy eating practices are associated with better clinical results. Thus, this study aims to evaluate the effect of a nutritional intervention on QoL and on gastrointestinal and hematological toxicities resulting from chemotherapy in women with breast cancer. A randomized clinical trial was performed at the beginning of neoadjuvant chemotherapy treatment for women with breast cancer. All participants received nutritional advice on healthy eating practices, but only the intervention group (IG) received an individualized diet plan. The study enrolled 34 women, 19 in the IG and 15 in the control group (CG). During the study, the CG significantly presented a reduction (from 21.6 ± 5.9 kg to 18.8 ± 4.0 kg, p = 0.009) in handgrip strength (HGS), while the IG did not present changes in this variable. Regarding QoL, the IG preserved the role function during treatment and presented better results for nausea/vomiting and loss of appetite compared to the CG. In gastrointestinal and hematological toxicities, the IG had lower frequencies of leukopenia and abdominal pain. The nutritional intervention preserved the role function of QoL and HGS, reduced the occurrence of nausea/vomiting, loss of appetite and the frequency of leukopenia and abdominal pain.

Keywords: breast cancer; diet; neoplasm; quality of life; toxicity.

Figure 1

Steps of data collection. Abbreviations: CC, Calf Circumference; HGS, Handgrip strength; QoL, Quality of life; PG-SGA, Patient-Generated Subjective Global Assessment.

Figure 2

Flowchart of the randomized clinical trial.

Figure 3

Comparison of global health/QoL and functional scales by the EORTC QLQ-C30 between the nutritional intervention and control groups throughout the study. (A) Global health status/QoL; (B) Physical functioning; (C) Role functioning; (D) Emotional functioning; (E) Cognitive functioning; (F) Social functioning. Abbreviations: Data presented as mean and standard deviation. T₀, study baseline, pre-chemotherapy moment; T₁, regarding the end of the first chemotherapy cycle; T₂, regarding the end of the second chemotherapy cycle; T₃, regarding the end of the third cycle of chemotherapy. ^a represents a statistical difference from T2 in the control group (p = 0.004).