23 mei 2017: Bron: De CALGB 89803 (Alliance) clinical trial

Een gezonde leefstijl waaronder letten op voeding, drinken (geen alcohol) en fysieke activiteiten heeft grote invloed op de ziektevrije tijd en overall overleving van darmkankerpatiënten. Als alcohol niet wordt meegerekend 42 procent minder kans op een recideif en te overlijden en als alcohol wel wordt meegerekend 51 procent minder kans op een recidief en overlijden. Dit blijkt uit de CALGB 89803 (Alliance) studie  in de periode 1999 tot 2001 door de NCIS.

Lifestijl foto bewerkt

In de studie werden darmkankerpatienten gevolgd na hun eerste diagnose en behandeling. Van de patienten (follow-up duur van 7 jaar) werden gevolgd kwamen deze resultaten uit de bus:

Kernpunten uit de studie:

  • The 91 survivors who had the highest healthy lifestyle scores had a 42% lower risk of death and a trend for reduced chance of recurrence than the 262 survivors with the lowest lifestyle scores.
  • When drinking alcohol was included in the score, the 162 survivors with the highest lifestyle score had a 51% lower chance of death and a 36% lower chance of cancer recurrence than the 187 survivors who had the lowest healthy lifestyle scores.
  • The associations were not driven by any particular lifestyle factor; body weight, regular physical activity, and a healthy diet were all important. 

“Er zijn meer dan 1.3 millioen overlevenden van darmkanker in de United States. Deze patienten hebben zorg nodig voor overlevenden van kanker inclusief begeleding en wat zij kunnen doen om een recidef te vooorkomen,” zegt onderzoeksleider en auteur Erin Van Blarigan, ScD, Assistant Professor of Epidemiology and Biostatistics, University of California, San Francisco. “Als antwoord op vragen van patienten en de noodzaak van begeleding heeft de American Cancer Society (ACS) richtlijnen gepubliceerd over voeding en fysieke activiteiten: ‘Nutrition and Physical Activity Guidelines for Cancer Survivors’ in 2012, maar het is niet bekend of patienten die deze richtlijnen volgen ook betere kansen hebben op overleven.”

Studiersultaten in het Engels:

Over a median follow-up of 7 years, the 91 survivors who had the highest healthy lifestyle scores (5–6 points) had a 42% lower risk of death and a trend for reduced chance of recurrence than the 262 survivors with the lowest lifestyle scores (0–1 points). When drinking alcohol was included in the score, the 162 survivors with the highest lifestyle score (6–8 points) had a 51% lower chance of death and a 36% lower chance of cancer recurrence than the 187 survivors who had the lowest healthy lifestyle scores (0–2 points). The associations were not driven by any particular lifestyle factor; body weight, regular physical activity, and a healthy diet were all important.

Conclusie:

In deze studie vonden wij dat de recidiefkansen en overall overleving van darmkankerpatienten die deze ACS richtljnen volgden is gerelateerd aan een langere ziektevrije tijd en overall overleving.

De studie: American Cancer Society (ACS) Nutrition and Physical Activity Guidelines after colon cancer diagnosis and disease-free (DFS), recurrence-free (RFS), and overall survival (OS) in CALGB 89803 (Alliance).

wordt gepresenteerd op 2 en 3 juni op ASCO 2017.

Hieronder ook dit abstract.

Healthy Lifestyle After Colon Cancer Diagnosis Helps Extend Survival

American Cancer Society (ACS) Nutrition and Physical Activity Guidelines after colon cancer diagnosis and disease-free (DFS), recurrence-free (RFS), and overall survival (OS) in CALGB 89803 (Alliance).

Sub-category:
Survivorship

Category:
Patient and Survivor Care

Meeting:
2017 ASCO Annual Meeting

Abstract No:
10006

Citation:
J Clin Oncol 35, 2017 (suppl; abstr 10006)

Author(s): Erin Van Blarigan, Charles S. Fuchs, Donna Niedzwiecki, Xing Ye, Sui Zhang, Mingyang Song, Leonard Saltz, Robert J. Mayer, Rex B. Mowat, Renaud Whittom, Alexander Hantel, Al Bowen Benson, Daniel M. Atienza, Michael J. Messino, Hedy L. Kindler, Alan P. Venook, Shuji Ogino, Walter C. Willett, Edward L. Giovannucci, Jeffrey A. Meyerhardt; University of California, San Francisco, San Francisco, CA; Dana-Farber Cancer Institute/Partners CancerCare, Boston, MA; Duke University Medical Center, Durham, NC; Duke University, Durham, NC; Harvard T.H. Chan School of Public Health, Boston, MA; Memorial Sloan-Kettering Cancer Center, New York, NY; Toledo Clinic, Toledo, OH; Hospital Sacre-Coeur de Montreal, Montreal, QC, Canada; Edward Cancer Center, Naperville, IL; Northwestern University, Chicago, IL; Virginia Oncology Associates, Suffolk, VA; Cancer Care of WNC PA, Asheville, NC; University of Chicago, Chicago, IL; Brigham and Women's Hospital, Boston, MA; Harvard T.H. Chan School of Public Health, Harvard Medical School, Brigham and Women's Hospital, Boston, MA

Abstract Disclosures

Abstract:

Background: The ACS Nutrition and Physical Activity Guidelines for Cancer Survivors include: 1) healthy body weight; 2) physical activity; and 3) a diet high in vegetables, fruits, and whole grains. It is not known whether colon cancer patients who follow these guidelines have improved DFS, RFS, or OS.

Methods: We conducted a prospective study among 992 stage III colon cancer patients enrolled in an adjuvant chemotherapy trial in 1999-2001. Lifestyle was assessed twice. We applied a score developed by McCullough ML et al. to quantify adherence to the ACS guidelines based on BMI; physical activity; and intake of vegetables, fruits, whole grains, and red/processed meats (range: 0-6; higher = more healthy behaviors). Alcohol is included in the ACS guidelines for cancer prevention, but not cancer survivors; we tested the score without and with alcohol using McCullough et al.’s cut points: 0 pts = >1/d for women, >2/d for men; 1 pt = no alcohol; 2 pts = >0-1/d for women, >0-2/d for men. We estimated hazard ratios (HR) and 95% confidence intervals (CI) for DFS, RFS, and OS adjusting for clinical, demographic, and lifestyle factors.

Results: Over 7 y median follow-up, we observed 335 recurrences and 299 deaths (43 without recurrence). Compared to patients with 0-1 pt (262, 26%), patients with 5-6 pts (91, 9%) had 42% lower risk of death (HR: 0.58; 95% CI: 0.34, 0.99; p-trend: 0.01) and a trend toward improved DFS (HR: 0.69; 95% CI: 0.45, 1.06; p-trend: 0.03). When including alcohol in the score, the adjusted HR’s comparing patients with 6-8 pts (162; 16%) to 0-2 pts (187; 91%) were: 0.49 for OS (95% CI: 0.32, 0.76; p-trend: 0.002), 0.58 for DFS (95% CI: 0.40, 0.84; p-trend: 0.01), and 0.64 for RFS (95% CI: 0.44, 0.94; p-trend: 0.05).

Conclusions: Colon cancer patients with a healthy body weight who engaged in physical activity, ate a diet high in whole grains, vegetables, and fruits and low in red/processed meats, and drank moderate alcohol had longer DFS and OS than patients who did not engage in these behaviors. Support: U10CA180821, U10CA180882, U10CA180820, K07CA197077, R01CA118553, P50CA127003, R35CA197735. ClinicalTrials.gov:NCT00003835.

darmkanker, chemo, xeloda - capecitabine, overall overleving, ziektevrije tijd, progressie vrije tijd, complementair, RAF, Radio Frequency Ablation, TACE, dr. Vogl, leefstijl, voeding, alcohol


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