Prospective study of the energy balance disruption during adjuvant chemotherapy in post-menopausal early-stage breast cancer patient

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Prospective Study on Body Composition, Energy Balance and Biological Factors Changes in Post-menopausal Women with Breast Cancer Receiving Adjuvant Chemotherapy Including Taxanes

International audienceIn breast cancer patients, weight and fat mass changes observed after chemotherapy have been related to poor prognosis but some recent works using modern chemotherapy failed to find this correlation with weight gain. In this study, the extent of changes in weight and body composition (DEXA, impedance) was characterized until six months after current chemotherapy, in 50 post-menopausal women with breast cancer. The evolution of factors contributing to the energy balance and some biological factors were also described. During chemotherapy, 20% of women lost weight due to both fat (-13.1% ± 10.3) and lean soft tissue mass loss (-3.6% ± 4.6). Twenty percent of women gained weight. No significant fat mass gain was observed in these women but significant water gain was highlighted. Six months later, women who gained weight presented a gain in fat mass (15.4% ± 19.0), especially in the abdominal region. Age and initial BMI were negatively correlated with fat mass in multivariate analyzes (r = 0.486, P = 0.0030). No significant variation of the glucose homeostasis, triglycerides, and HDL-Cholesterol was found six months after chemotherapy. These results do not suggest major adverse metabolic disturbances six months after modern chemotherapy and only a mild fat mass gain was observed in women who gained weight

Weight Evolution During Endocrine Therapy for Breast Cancer in Postmenopausal Patients: Effect of Initial Fat Mass Percentage and Previous Adjuvant Treatments

International audiencePurpose: Weight change during adjuvant treatment for early breast cancer is associated with poor prognosis. The long-term evolution of body composition during adjuvant treatment for breast cancer, particularly endocrine therapy, is not well known and new data on this topic is required. The present study assesses the evolution of weight and body composition among 33 postmenopausal breast cancer patients currently treated with endocrine therapy after standard adjuvant chemotherapy including Taxanes.Patients and Methods: Dual-Energy X-ray Absorptiometry (DXA) was used to measure fat and lean body mass. Body water was assessed by multifrequency bioelectrical impedance analysis. The HAD questionnaire and the short version of the IPAQ were also administered.Results: During endocrine therapy, 15.2% (n=5) of the population lost weight and 36.4% (n=12) gained weight. The overall average gain was 2.0kg ±5.5 (p= 0.04). During this period, fat mass, lean body mass and body water increased. Factors linked to fat mass gain are excess fat mass (≥36%) before treatment and weight loss during chemotherapy. In the overall period of adjuvant cancer treatment, 30% of the population gained more than 5% of their initial weight. The average gain was the same as during the endocrine therapy period (2.0kg ±5.4; p=0.031) and was characterized by an increase in total lean body mass, mainly localized in the trunk region.Conclusion: Endocrine therapy appears as a pivotal period in weight and body composition management. Overfat/obese patients and those who lose weight during chemotherapy are more subject to weight and fat mass gain during endocrine therapy

Improvement in adherence to Capecitabine and Lapatinib by way of a therapeutic education program

International audienceA patient non-adherence with oral anticancer agents is a well-recognized barrier to effective treatment. The aim of this prospective study was to evaluate the efficacy of a therapeutic education program among non-adherent patients treated with Capecitabine alone or associated with Lapatinib

Cognitive mechanisms underlying reading and spelling development in five European orthographies

This paper addresses the question whether the cognitive underpinnings of reading and spelling are universal or language/orthography-specific. We analyzed concurrent predictions of phonological processing (awareness and memory) and rapid automatized naming (RAN) for literacy development in a large European sample of 1062 typically developing elementary school children beyond Grade 2 acquiring five different alphabetic orthographies with varying degrees of graphemeephoneme consistency (English, French, German, Hungarian, Finnish). Findings indicate that (1) phonological processing and RAN both account for significant amounts of unique variance in literacy attainment in all five orthographies. Associations of predictors with reading speed, reading accuracy, and spelling are differential: in general, RAN is the best predictor of reading speed while phonological processing accounts for higher amounts of unique variance in reading accuracy and spelling; (2) the predictive patterns are largely comparable across orthographies, but they tend to be stronger in English than in all other orthographies

Predictors of developmental dyslexia in European orthographies with varying complexity.

International audienceBACKGROUND: The relationship between phoneme awareness, rapid automatized naming (RAN), verbal short-term/working memory (ST/WM) and diagnostic category is investigated in control and dyslexic children, and the extent to which this depends on orthographic complexity. METHODS: General cognitive, phonological and literacy skills were tested in 1,138 control and 1,114 dyslexic children speaking six different languages spanning a large range of orthographic complexity (Finnish, Hungarian, German, Dutch, French, English). RESULTS: Phoneme deletion and RAN were strong concurrent predictors of developmental dyslexia, while verbal ST/WM and general verbal abilities played a comparatively minor role. In logistic regression models, more participants were classified correctly when orthography was more complex. The impact of phoneme deletion and RAN-digits was stronger in complex than in less complex orthographies. CONCLUSIONS: Findings are largely consistent with the literature on predictors of dyslexia and literacy skills, while uniquely demonstrating how orthographic complexity exacerbates some symptoms of dyslexia