DOI: http://dx.doi.org/10.18203/2349-3933.ijam20214126

Relationship between anemia, hypoalbuminemia, vitamin D deficiency and quality of life in advanced non-small cell lung carcinoma patients at tertiary hospital in Bali

I. B. P. Ekaruna, Ketut Suryana, Jasminarti D. K., N. W. Candrawati, N. L. P. Eka Arisanti, I. G. K. Sajinadiyasa, I. B. N. Rai

Abstract


Background: The main purpose of treatment in patients with advanced lung cancer is more emphasizing on prolonging survival and improving the patient's quality of life (QOL). Micronutrient deficiency has an impact on the patient's QOL. The purpose of this study was to analyse the relationship between biochemical parameters of nutrient deficiency with QOL in patients with advanced non-small cell carcinoma (NSCLC) at Sanglah hospital.

Methods: A cross sectional study was conducted in Sanglah general hospital on March-June 2021. Hemoglobin, albumin, and 2.5 (OH) D levels were obtained from patient's serum. The participant’s QOL was measured with EQ-5D-3L questionnaire. Bivariate analysis using chi-square test or Fisher's exact test, and multivariate analysis using logistic regression.

Results: A total of 80 participants were included in this study, and 55% had poor QOL. Seventy percent participants had anemia, 36.3% had hypoalbuminemia, and 26.3% had vitamin D deficiency. The QOL of patients with advanced stage NSCLC was significantly associated with hypoalbuminemia (p=0.000) and vitamin D deficiency (p=0.044). Multivariate analysis showed that the most influential factor on the QOL of patients with advanced stage NSCLC was hypoalbuminemia (AOR 9.158; 95% CI 2.150-30.001; p=0.003).

Conclusions: Hypoalbuminemia and vitamin D deficiency were significantly related with QOL of advance NSCLC patients. No relationship was found between anemia and the QOL of advance NSCLC patients. Hypoalbuminemia was the most influential factors related to the QOL of advance NSCLC patients.


Keywords


Anemia, Hypoalbuminemia, Vitamin D deficiency, QOL, Advanced NSCLC

Full Text:

PDF

References


Bray F, Ferlay J, Soerjomataram I, Siegel R, Torre L, Jemal A. Global Cancer Statistics 2018 : GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2018;68:394-424.

Milosevic B, Pejic D, Momcicevic D, Kovacevic P, Stanetic M, Dragic S. Quality of life in lung cancer patients due to treatment. Signa Vitae. 2016;11(2):47-50.

Polanski J, Jankowska-Polanska B, Rosinczuk J, Chabowski M, Szymanska-Chabowska A. Quality of life of patients with lung cancer. Onco Target Ther. 2016;9:1023-8.

Gröber U, Holzhauer P, Kisters K, Holick MF, Adamietz IA. Micronutrients in Oncological Intervention. Nutrients. 2016;8(163):1-30.

Supartono, Suryanto A. Faktor-faktor yang mempengaruhi ketahanan hidup satu tahun penderita kanker paru stadium lanjut di RSUP Dr. Kariadi Semarang. Medica Hosp. 2012;1(1):25-31.

Madeddu C, Gramignano G, Astara G, Demontis R, Sanna E, Atzeni V et al. Pathogenesis and Treatment Options of Cancer Related Anemia : Perspective for a Targeted Mechanism-Based Approach. Front Physiol. 2018;9:1-20.

Siregar YS, Widyaningsih W, Syahruddin E. Indeks Massa Tubuh , Persentase Otot Rangka dan Albumin pada Pasien Kanker Paru Karsinoma Bukan Sel Kecil Sebelum dan Setelah Kemoterapi Chemotherapy. J Respir Indo. 2016;36(2):73-82.

Rozga J, Piątek T, Małkowski P. Human albumin : old, new, and emerging applications. Ann Transplant. 2013;18:205-17.

Soejitno A, Kuswardhani RAT. Defisiensi vitamin D: mekanisme, implikasi, dan terapi pada lansia. Cermin Dunia Kedokt. 2009;36(2):81-3.

Foong RE, Zosky GR. Vitamin D Deficiency and the Lung : Disease Initiator. Nutrients. 2013;5:2880-900.

Jusuf A, Yahya WS, Hermansyah E. Epidemiologi Kanker Paru. In: Jusuf A, editor. Dasar Dasar Diagnosis Kanker Paru. 1st ed. Jakarta: Penerbit Universitas Indonesia; 2017;1-7.

Barta JA, Powell CA, Wisnivesky JP. Global epidemiology of lung cancer. Ann Glob Heal. 2019;85(1):1-16.

Froudarakis ME. Pleural Effusion in Lung Cancer : More Questions than Answers. Respiration. 2012;83:367-76.

Ana F. Kesintasan Satu Tahun Penderita Karsinoma Paru Non-Small Cell Usia Lanjut Stadium IIIb/IV Yang Menjalani Kemoterapi Dibandingkan Dengan Non-Kemoterapi. 2014;1-129.

Hechtner M, Eichler M, Wehler B, Buhl R, Sebastian M, Stratmann J et al. Quality of Life in NSCLC Survivors-A Multicenter Cross-Sectional Study. J Thorac Oncol. 2018;14(3):420-35.

Busti F, Marchi G, Ugolini S, Castagna A, Girelli D. Anemia and Iron Deficiency in Cancer Patients : Role of Iron Replacement Therapy. Pharmaceuticals. 2018;1-14.

Xu C, Gao Y, Li L, Xing L, Liu S. Impact of Anemia on Chemotherapy Efiicacy and Prognosis in Patients with Advanced Non-small Cell Lung Cancer. Chin J Lung Cancer. 2010;13(10):968-74.

Barca-hernando M, Muñoz-martin AJ, Rios-herranz E, Garcia-escobar I, Beato C, Font C et al. Case-Control Analysis of the Impact of Anemia on Quality of Life in Patients with Cancer : A Qca Study Analysis. MDPI. 2021;13(2517):1-11.

Wright JR, Ung YC, Julian JA, Pritchard KI, Whelan TJ, Smith C et al. Randomized, Double-Blind ,Placebo-Controlled Trial of Erythropoietin in Non-Small-Cell Lung Cancer With Disease-Related Anemia. J Clin Oncol. 2007;25(9):1027-32.

Carnio S, Stefano RF Di, Novello S. Fatigue in lung cancer patients : symptom burden and management of challenges. Lung Cancer Targets Ther. 2016;7:73-82.

Holzner B, Kemmler G, Greil R, Kopp M, Zeimet A, Raderer M et al. The impact of hemoglobin levels on fatigue and quality of life in cancer patients. Ann Oncol. 2002;13(6):965-73.

Arrieta O, Ortega RMM, Villanueva-rodríguez G, Serna-thomé MG, Flores-estrada D, Diaz-romero C et al. Association of nutritional status and serum albumin levels with development of toxicity in patients with advanced non-small cell lung cancer treated with paclitaxel-cisplatin chemotherapy: a prospective study. BMC Cancer. 2010;10(50):1-7.

Ikeda S, Yoshioka H, Ikeo S, Morita M, Sone N, Niwa T et al. Serum albumin level as a potential marker for deciding chemotherapy or best supportive care in elderly , advanced non- small cell lung cancer patients with poor performance status. BMC Cancer. 2017;17(797):1-8.

Takayama K, Atagi S, Imamura F, Tanaka H, Minato K. Quality of life and survival survey of cancer cachexia in advanced non-small cell lung cancer patients-Japan nutrition and QOL survey in patients with advanced non-small cell lung cancer study. Support Care Cancer. 2016;24:3473-80.

Vashi PG, Edwin P, Popiel B, Gupta D. The relationship between circulating 25-hydroxyvitamin D and survival in newly diagnosed advanced non-small-cell lung cancer. BMC Cancer. 2015;15(1012):1-9.

Ma K, Xu W, Wang C, Li B, Su K, Li W. Vitamin D deficiency is associated with a poor prognosis in advanced non-small cell lung cancer patients treated with platinum-based first-line chemotherapy uncorrect proof version of versioncorre. Cancer Biomarkers. 2016;1:1-7.

Chao YS, Ekwaru JP, Ohinmaa A, Griener G, Veugelers PJ. Vitamin D and health-related quality of life in a community sample of older Canadians. Qual Life Res. 2014;23:2569-75.

Helde-Frankling M, Höijer J, Bergqvist J, Björkhem-Bergman L. Vitamin D supplementation to palliative cancer patients shows positive effects on pain and infections-Results from a matched case-control study. PLoS One. 2017;12(8):1-14.

Martínez-Alonso M, Dusso A, Ariza G, Nabal M. Vitamin D deficiency and its association with fatigue and quality of life in advanced cancer patients under palliative care: A cross-sectional study. Palliat Med. 2016;30(1):89-96.

Wang X, Han H, Duan Q, Khan U, Hu Y, Yao X. Changes of serum albumin level and systemic inflammatory response in inoperable non‑small cell lung cancer patients after chemotherapy. J od Cancer Res Ther. 2014;10(4):1019-23.