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:
Corresponding author: Fang Liu, MD, Associate Chief Physician, Department of Radiotherapy, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China.
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
Research background

Few studies have examined the changes in vitamin nutritional status and their influencing factors during chemotherapy for esophageal cancer (EC). Most vitamins were found to be negatively associated with the risk of colorectal and gastric cancer in addition to EC, yet interventional treatment failed to demonstrate a clear preventive effect in these malignancies. In our study, the effects of chemotherapeutic drugs on EC patients’ vitamin levels and hematological indicators were analyzed.

Research motivation

We analyzed the effects of chemotherapeutic drugs on EC patients’ vitamin levels and hematological indicators by detecting the changes in nine vitamins and hematological indicators before and after chemotherapy, with an attempt to provide evidence for vitamin supplementation. Many oncologists believe that vitamin testing is valuable in tumor patients as it can identify whether there is a specific vitamin deficiency and/or justify vitamin therapy. Our findings may be valuable for the implementation of tailored nutritional interventions.

Research objectives

To explore multiple vitamin levels and the possible influential factors in EC patients treated with chemotherapy. Varying degrees of vitamin deficiency and weight loss were found in these patients. Vitamin supplementation may reduce the adverse effects of chemotherapy.

Research methods

Vitamin nutritional status was measured using the electrochemiluminescence method with an LK3000VI vitamin detector before and after two cycles of chemotherapy in EC patients. Statistical analysis was performed using the SPSS 24.0 software package. The latent correlations between multiple vitamin levels (the independent variables) and body mass index (the dependent variable) during chemotherapy were analyzed using the Spearman method.

Research results

Varying degrees of vitamin A, D, C and B2 deficiency and weight loss were found in EC patients. Statistically significant differences were shown in vitamins A, C, B2 and B6 levels and body mass index before and after chemotherapy. Multivariate analysis showed that vitamin A levels significantly differed between male and female EC patients, whereas vitamin D concentrations significantly differed in EC patients in different stages. Correlations were observed between the changes in serum vitamin A and C levels pre- and postchemotherapy and the variation in body mass index.

Research conclusions

Varying degrees of vitamin deficiency and weight loss were found in EC patients undergoing chemotherapy. Vitamin supplementation may help to improve the nutritional status, chemotherapy tolerance and efficacy. To detect the concentrations of vitamins is valuable for EC patients.

Research perspectives

A multicenter prospective study should be performed to reveal the suitable vitamin replenishment programs and potential effects on treatment outcomes and the adverse effects of chemotherapy in EC patients. Thus, randomized control studies and intervention are needed to verify our finding.