Weight change trajectory in women with breast cancer receiving chemotherapy and the effect of different regimens

Li Ni Liu, Fur Hsing Wen, Christine Miaskowski, Yung Chang Lin, Jong Shyan Wang, Chii Jeng, Mei Ling Chen

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Aims and objectives: To investigate the trajectory of weight change in Taiwanese women with breast cancer after starting chemotherapy and the impact of chemotherapy regimens on weight change while controlling for age, menopausal status, body mass index, lymph node involvement and changes in habits of dietary fat intake and exercise. Background: Weight gain after adjuvant chemotherapy in women with breast cancer has negative impact on health outcomes. Design: Longitudinal, clinical observational study. Methods: Weights were repeatedly measured in 147 women with breast cancer stages I-III. Hierarchical linear modelling was used to analyse these longitudinal data. Results: The overall pattern of weight change was a cubic form beginning with a mean of 56·9 kg before chemotherapy. It gradually increased to 59·4 kg at 8·5 months after the first chemotherapy followed by a decrease to 58·5 kg at 21·5 months. During the last 2·5 months, weight increased slightly and never returned to the initial level. After controlling for confounders, steeper weight change was observed among women receiving cyclophosphamide, methotrexate and fluorouracil. The highest weight gain in the cyclophosphamide, methotrexate and fluorouracil group was 2·9 kg (5%) vs. 0·9 kg (1%) in the anthracycline-based group. Conclusion: The trajectory of body weight change within two years after chemotherapy shows a trend of gradual ascent, followed by a small decline and a slight increase in the last 2·5 months. The chemotherapy regimen can predict the trend after controlling for other confounders; women on cyclophosphamide, methotrexate and fluorouracil have a steeper weight change. Relevance to clinical practice: Nurses can inform women with breast cancer about the expected changes in body weight after chemotherapy to reduce their uncertainty. Future studies on effective interventions to minimise chemotherapy-induced weight gain are needed.

Original languageEnglish
Pages (from-to)2757-2768
Number of pages12
JournalJournal of Clinical Nursing
Volume23
Issue number19-20
DOIs
Publication statusPublished - Oct 1 2014

Fingerprint

Breast Neoplasms
Weights and Measures
Drug Therapy
Methotrexate
Fluorouracil
Cyclophosphamide
Weight Gain
Body Weight Changes
Dietary Fats
Anthracyclines
Adjuvant Chemotherapy
Uncertainty
Habits
Observational Studies
Body Mass Index
Lymph Nodes
Nurses
Exercise
Health

Keywords

  • Breast cancer
  • Chemotherapy regimens
  • Hierarchical linear models
  • Trajectory of body weight change

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Weight change trajectory in women with breast cancer receiving chemotherapy and the effect of different regimens. / Liu, Li Ni; Wen, Fur Hsing; Miaskowski, Christine; Lin, Yung Chang; Wang, Jong Shyan; Jeng, Chii; Chen, Mei Ling.

In: Journal of Clinical Nursing, Vol. 23, No. 19-20, 01.10.2014, p. 2757-2768.

Research output: Contribution to journalArticle

Liu, Li Ni ; Wen, Fur Hsing ; Miaskowski, Christine ; Lin, Yung Chang ; Wang, Jong Shyan ; Jeng, Chii ; Chen, Mei Ling. / Weight change trajectory in women with breast cancer receiving chemotherapy and the effect of different regimens. In: Journal of Clinical Nursing. 2014 ; Vol. 23, No. 19-20. pp. 2757-2768.
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abstract = "Aims and objectives: To investigate the trajectory of weight change in Taiwanese women with breast cancer after starting chemotherapy and the impact of chemotherapy regimens on weight change while controlling for age, menopausal status, body mass index, lymph node involvement and changes in habits of dietary fat intake and exercise. Background: Weight gain after adjuvant chemotherapy in women with breast cancer has negative impact on health outcomes. Design: Longitudinal, clinical observational study. Methods: Weights were repeatedly measured in 147 women with breast cancer stages I-III. Hierarchical linear modelling was used to analyse these longitudinal data. Results: The overall pattern of weight change was a cubic form beginning with a mean of 56·9 kg before chemotherapy. It gradually increased to 59·4 kg at 8·5 months after the first chemotherapy followed by a decrease to 58·5 kg at 21·5 months. During the last 2·5 months, weight increased slightly and never returned to the initial level. After controlling for confounders, steeper weight change was observed among women receiving cyclophosphamide, methotrexate and fluorouracil. The highest weight gain in the cyclophosphamide, methotrexate and fluorouracil group was 2·9 kg (5{\%}) vs. 0·9 kg (1{\%}) in the anthracycline-based group. Conclusion: The trajectory of body weight change within two years after chemotherapy shows a trend of gradual ascent, followed by a small decline and a slight increase in the last 2·5 months. The chemotherapy regimen can predict the trend after controlling for other confounders; women on cyclophosphamide, methotrexate and fluorouracil have a steeper weight change. Relevance to clinical practice: Nurses can inform women with breast cancer about the expected changes in body weight after chemotherapy to reduce their uncertainty. Future studies on effective interventions to minimise chemotherapy-induced weight gain are needed.",
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AU - Jeng, Chii

AU - Chen, Mei Ling

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N2 - Aims and objectives: To investigate the trajectory of weight change in Taiwanese women with breast cancer after starting chemotherapy and the impact of chemotherapy regimens on weight change while controlling for age, menopausal status, body mass index, lymph node involvement and changes in habits of dietary fat intake and exercise. Background: Weight gain after adjuvant chemotherapy in women with breast cancer has negative impact on health outcomes. Design: Longitudinal, clinical observational study. Methods: Weights were repeatedly measured in 147 women with breast cancer stages I-III. Hierarchical linear modelling was used to analyse these longitudinal data. Results: The overall pattern of weight change was a cubic form beginning with a mean of 56·9 kg before chemotherapy. It gradually increased to 59·4 kg at 8·5 months after the first chemotherapy followed by a decrease to 58·5 kg at 21·5 months. During the last 2·5 months, weight increased slightly and never returned to the initial level. After controlling for confounders, steeper weight change was observed among women receiving cyclophosphamide, methotrexate and fluorouracil. The highest weight gain in the cyclophosphamide, methotrexate and fluorouracil group was 2·9 kg (5%) vs. 0·9 kg (1%) in the anthracycline-based group. Conclusion: The trajectory of body weight change within two years after chemotherapy shows a trend of gradual ascent, followed by a small decline and a slight increase in the last 2·5 months. The chemotherapy regimen can predict the trend after controlling for other confounders; women on cyclophosphamide, methotrexate and fluorouracil have a steeper weight change. Relevance to clinical practice: Nurses can inform women with breast cancer about the expected changes in body weight after chemotherapy to reduce their uncertainty. Future studies on effective interventions to minimise chemotherapy-induced weight gain are needed.

AB - Aims and objectives: To investigate the trajectory of weight change in Taiwanese women with breast cancer after starting chemotherapy and the impact of chemotherapy regimens on weight change while controlling for age, menopausal status, body mass index, lymph node involvement and changes in habits of dietary fat intake and exercise. Background: Weight gain after adjuvant chemotherapy in women with breast cancer has negative impact on health outcomes. Design: Longitudinal, clinical observational study. Methods: Weights were repeatedly measured in 147 women with breast cancer stages I-III. Hierarchical linear modelling was used to analyse these longitudinal data. Results: The overall pattern of weight change was a cubic form beginning with a mean of 56·9 kg before chemotherapy. It gradually increased to 59·4 kg at 8·5 months after the first chemotherapy followed by a decrease to 58·5 kg at 21·5 months. During the last 2·5 months, weight increased slightly and never returned to the initial level. After controlling for confounders, steeper weight change was observed among women receiving cyclophosphamide, methotrexate and fluorouracil. The highest weight gain in the cyclophosphamide, methotrexate and fluorouracil group was 2·9 kg (5%) vs. 0·9 kg (1%) in the anthracycline-based group. Conclusion: The trajectory of body weight change within two years after chemotherapy shows a trend of gradual ascent, followed by a small decline and a slight increase in the last 2·5 months. The chemotherapy regimen can predict the trend after controlling for other confounders; women on cyclophosphamide, methotrexate and fluorouracil have a steeper weight change. Relevance to clinical practice: Nurses can inform women with breast cancer about the expected changes in body weight after chemotherapy to reduce their uncertainty. Future studies on effective interventions to minimise chemotherapy-induced weight gain are needed.

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KW - Hierarchical linear models

KW - Trajectory of body weight change

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