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    Randomised controlled trial of intermittent vs continuous energy restriction during chemotherapy for early breast cancer

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    Authors
    Harvie, M.
    Pegington, M.
    Howell, S. J.
    Bundred, N.
    Foden, P.
    Adams, J.
    Graves, L.
    Greystoke, A.
    Mattson, M. P.
    Cutler, R. G.
    Williamson, J.
    Livingstone, K.
    McMullen, D.
    Sellers, K.
    Lombardelli, C.
    Cooper, G.
    McDiarmid, S.
    Howell, A.
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    Affiliation
    Prevent Breast Cancer Research Unit, The Nightingale Centre, Manchester University NHS Foundation Trust, Manchester, England
    Issue Date
    2021
    
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    Abstract
    Background Excess adiposity at diagnosis and weight gain during chemotherapy is associated with tumour recurrence and chemotherapy toxicity. We assessed the efficacy of intermittent energy restriction (IER) vs continuous energy restriction (CER) for weight control and toxicity reduction during chemotherapy. Methods One hundred and seventy-two women were randomised to follow IER or CER throughout adjuvant/neoadjuvant chemotherapy. Primary endpoints were weight and body fat change. Secondary endpoints included chemotherapy toxicity, cardiovascular risk markers, and correlative markers of metabolism, inflammation and oxidative stress. Results Primary analyses showed non-significant reductions in weight (−1.1 (−2.4 to +0.2) kg, p = 0.11) and body fat (−1.0 (−2.1 to +0.1) kg, p = 0.086) in IER compared with CER. Predefined secondary analyses adjusted for body water showed significantly greater reductions in weight (−1.4 (−2.5 to −0.2) kg, p = 0.024) and body fat (−1.1 (−2.1 to −0.2) kg, p = 0.046) in IER compared with CER. Incidence of grade 3/4 toxicities were comparable overall (IER 31.0 vs CER 36.5%, p = 0.45) with a trend to fewer grade 3/4 toxicities with IER (18%) vs CER (31%) during cycles 4–6 of primarily taxane therapy (p = 0.063). Conclusions IER is feasible during chemotherapy. The potential efficacy for weight control and reducing toxicity needs to be tested in future larger trials.
    Citation
    Harvie M, Pegington M, Howell SJ, Bundred N, Foden P, Adams J, et al. Randomised controlled trial of intermittent vs continuous energy restriction during chemotherapy for early breast cancer. British Journal of Cancer.11.
    Journal
    Br J Cancer
    URI
    http://hdl.handle.net/10541/625025
    DOI
    10.1038/s41416-021-01650-0
    PubMed ID
    34912072
    Additional Links
    https://dx.doi.org/10.1038/s41416-021-01650-0
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1038/s41416-021-01650-0
    Scopus Count
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