Observational Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Dec 24, 2019; 10(12): 391-401
Published online Dec 24, 2019. doi: 10.5306/wjco.v10.i12.391
Role of Mediterranean diet in preventing platinum based gastrointestinal toxicity in gynecolocological malignancies: A single Institution experience
Eleonora Ghisoni, Valentina Casalone, Gaia Giannone, Gloria Mittica, Valentina Tuninetti, Giorgio Valabrega
Eleonora Ghisoni, Valentina Casalone, Gaia Giannone, Gloria Mittica, Valentina Tuninetti, Giorgio Valabrega, Candiolo Cancer Institute, FPO-IRCCS, Torino 10060 Italy
Eleonora Ghisoni, Gaia Giannone, Valentina Tuninetti, Giorgio Valabrega, University of Torino, Torino 10060, Italy
Author contributions: Valabrega G contributed to study conception and design; Ghisoni E and Casalone V contributed to data acquisition, data analysis and interpretation, and writing of article; Giannone G, Mittica G and Tuninetti V contributed to editing, reviewing, and final approval of the article.
Institutional review board statement: Observational study design and written informed consents were approved by the institutional review board of Candiolo Cancer Institute FPO/IRCCS.
Informed consent statement: All recruited patients signed the written informed consent and provide approval to participate to this observational study.
Conflict-of-interest statement: Authors have no conflicts of interest.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Giorgio Valabrega, MD, Assistant Professor, Candiolo Cancer Institute FPO-IRCCS, Torino 10060 Italy. giorgio.valabrega@ircc.it
Telephone: +39-11-9933253 Fax: +39-11-9933275
Received: March 6, 2019
Peer-review started: March 8, 2019
First decision: April 16, 2019
Revised: October 10, 2019
Accepted: November 5, 2019
Article in press: November 5, 2019
Published online: December 24, 2019
Processing time: 289 Days and 5.7 Hours
Abstract
BACKGROUND

Gynecological malignancies represent a major cause of death in women and are often treated with platinum-based regimens. Patients undergoing chemotherapy suffer from alterations in nutritional status which may worsen gastrointestinal (GI) toxicities, quality of life and affect the overall prognosis. Indeed, assuring a good nutritional status and limiting toxicities during treatment are still major goals for clinicians.

AIM

To assess the role of Mediterranean Diet (MD) in reducing GI toxicities in patients with gynecological cancers treated with platinum-based regimens.

METHODS

We conducted an observational study on 22 patients with gynecological tumors treated with a platinum-based chemotherapy at Candiolo Cancer Institute FPO/IRCCS between January 2018 and June 2018. The food and frequency (FFQ) and the Patient-Reported Outcomes Common Terminology Criteria For Adverse Events (PRO-CTCAE) questionnaires were administered at baseline and at every Day 1 of each cycle. To evaluate the differences in GI toxicities the study population was divided in two groups according to the currently validated Mediterranean Diet Serving Score (MDSS) at baseline.

RESULTS

Patients with high MDSS reported a trend toward lower GI toxicities according to PRO-CTCAE at each timepoint (first evaluation: P = 0.7; second: P = 0.52; third: P = 0.01). In particular, difference in nausea frequency and gravity (P < 0.001), stomach pain frequency and gravity (P = 0.01 and P = 0.02), abdomen bloating frequency and gravity (P = 0.02 and P = 0.03), and interference with daily activities (P = 0.02) were highly statistically significant at the end of treatment. More than 60% of patients changed their food habits during chemotherapy mainly because of GI toxicities. A higher reduction of food intake, both in terms of caloric (P = 0.29) and of single nutrients emerged in the group experiencing higher toxicity.

CONCLUSION

Our results show that adherence to MD possibly reduces GI toxicity and prevents nutritional status impairment during chemotherapy treatment. Bigger studies are needed to confirm our results.

Keywords: Mediterranean diet; Gynecological malignancies; Gastrointestinal toxicities; Platinum-based chemotherapy; Nutritional status

Core tip: Mediterranean diet possibly reduces gastro-intestinal toxicities and nutritional status impairment related to platinum-based chemotherapy in women affected by gynecological cancers.