The influence of low fat, low lactose diet on diarrhoea during pelvic radiotherapy.

摘要: Purpose. The main aim of the present study was to evaluate effect a low fat, lactose diet on acute and late gastrointestinal side effects pelvic radiotherapy. We also wanted if such treatment would influence patients health related quality life (HRQOL) in any way.Background. Cancer therapies their may cause nutritional problems malnutrition. Pelvic radiotherapy, common modality for with carcinoma endometrium or cervix, is associated both that affect status. Acute injury lead impaired absorption nutrients fluid. experience diarrhoea, weight loss, nausea vomiting. Bile salt malabsorption be factor pathogenesis diarrhoea. In cases bile fat will decreased excretion thereby relief symptoms. This assumption evaluated small, non-randomised 1985. results indicated reduce frequency diarrhoea use anti-diarrhoeal agents during These findings were regarded as promising since nutrition management guidelines radiation enteritis lacking literature, clinical trial planned.Methods. designed an open randomised conducted at Norwegian Radium Hospital (NRH). intervention (low lactose) followed six weeks after Measurements performed basement, 3rd last week then every 8th week. entire period one year. November 1993 surviving approached again asked complete questionnaire package similar completed trial. population recruited from department gynaecology NRH. selection criteria radiotherapy (dose above 40 Gy) age = 75 years WHO functional status 2. Patients consecutive included May 1988 through 1990 143 women included. Seventy-one assigned 72 control group. 1993, 94 alive without known relapse 79 (84%) accepted participation. registered Loperamid daily number consistency bowel movements. data movements categorised used not. Nutritional by means development, arm muscle circumference (AMC), serum transferring (STF) albumin (s-Alb). Dietary intake assessed 48-hour recall prior 4-days unweighed dietary record 7-days weighed records follow-up. 24-hour urinary nitrogen validate food records. HRQOL defined patients' self-reported subjective physical psychosocial situation consequence disease treatment. It measured EORTC Core Quality Life Questionnaire 36-item version (EORTC QLQ-C36).Results. During 14 (23%) group 32 (48%) reported (p< 0.01). less anti-diarrhoea medication than group, 0.6 tablets per day versus 1.1 (p<0.01). Six end no differences found regard medication. had lower energy 5.7 MJ 6.5 (p<0.05). mean respectively 34.3 g 60.1 (p<0.001). received significant part milk products, meats, fats sugar consumed more vegetables fruits, cereals fish. Weight loss pronounced (mean reduction 2.6 kg 1.7 kg) (ns) Mean values AMC, s-Alb STF within reference range groups observation period. (9%) 4 (6%) mildly depleted (ns). At 12 year none could malnourished. No major between two one-year follow up. Within association deteriorated role functioning, functioning fatigue not Regarding (3-4 radiotherapy) general population, 23.8 9.5 There however tendency (29.6 (SD=27.3)) (19.4 (SD=25.4)) though statistical significant. Substantial SF fatigue. Conclusions. Loperamide finding did groups. Both reduced increased negative functioning. chronic 3-4 but most prominent Diarrhoea social well being.