Effectiveness of a nutritional intervention in the reduction of gastrointestinal toxicity during teletherapy in women with gynaecological tumours

Abstract

Objective: To evaluate whether nutritional intervention through a diet low in oligosaccharides, disaccharides, monosaccharides and fermentable polyols reduces acute gastrointestinal toxicity by pelvic teletherapy in patients with gynaecological tumours. Material and methods: A prospective unicentric randomised clinical trial comparing patients on a diet low in oligosaccharides, disaccharides, monosaccharides and fermentable polyols versus a standard Mexican diet, designed to detect a decrease from 80% of grade 1–2 acute gastrointestinal toxicity in the normal diet group versus a 25% of acute gastrointestinal toxicity grade 1–2 in patients assigned to a diet low in oligosaccharides, disaccharides, monosaccharides and fermentable polyols. Results: Thirteen patients were recruited per group, with a higher gastrointestinal toxicity in the normal diet group, grade 1–2 (85% vs 77%) and 3 (23% vs 0%) compared to the diet low in oligosaccharides, disaccharides, monosaccharides and fermentable polyols (p 0.16). The diet low in oligosaccharides, disaccharides, monosaccharides and fermentable polyols group had a lower symptom score at the end of treatment in the quality of life questionnaire of patients with cervical cancer (1.41 vs 1.85, p 0.01) and a lower mean deterioration in performance status (0.61 of 0.5 vs 0.23 of 0.43, p 0.049). 85% of the patients had an excellent attachment to the diet. No significant factors associated with the presence of grade 3 gastrointestinal toxicity were found. Conclusion: The implementation of a diet low in oligosaccharides, disaccharides, monosaccharides and fermentable polyols during treatment with pelvic teletherapy is a low cost and high attachment intervention, which decreases the deterioration of functional status and symptomatology at the end of treatment in patients with cervical cancer.

Keywords

• Gynecologic tumours
• Diet low in oligosaccharides
• Disaccharides
• Monosaccharides and fermentable polyols
• Quality of life
• Gastrointestinal toxicity