Weight change trajectory in women with breast cancer receiving chemotherapy and the effect of different regimens
Article first published online: 7 JAN 2014
© 2014 John Wiley & Sons Ltd
Journal of Clinical Nursing
Volume 23, Issue 19-20, pages 2757–2768, October 2014
How to Cite
Liu, L.-N., Wen, F.-H., Miaskowski, C., Lin, Y.-C., Wang, J.-S., Jeng, C. and Chen, M.-L. (2014), Weight change trajectory in women with breast cancer receiving chemotherapy and the effect of different regimens. Journal of Clinical Nursing, 23: 2757–2768. doi: 10.1111/jocn.12521
- Issue published online: 22 SEP 2014
- Article first published online: 7 JAN 2014
- Manuscript Accepted: 29 OCT 2013
- National Science Council of Taiwan. Grant Number: 94-2314-B-182-025
- breast cancer;
- chemotherapy regimens;
- hierarchical linear models;
- trajectory of body weight change
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.
Weight gain after adjuvant chemotherapy in women with breast cancer has negative impact on health outcomes.
Longitudinal, clinical observational study.
Weights were repeatedly measured in 147 women with breast cancer stages I–III. Hierarchical linear modelling was used to analyse these longitudinal data.
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.
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.