Weight change during chemotherapy in breast cancer patients: A meta-analysis

M. M.G.A. Berg, Renate Winkels, J. Th C.M. Kruif, H. W.M. Laarhoven, M. Visser, J. H.M. Vries, Y. C. Vries, E. Kampman

Research output: Contribution to journalArticle

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Abstract

Background: Weight gain during chemotherapy in women with breast cancer is commonly reported. However, there are important differences between studies that examined weight change during chemotherapy; e.g. type of chemotherapy, menopausal status, time between body weight measurements and sample size. The purpose of this meta-analysis was to quantify changes in body weight during chemotherapy for women with breast cancer, taking these differences into account. Methods: We identified relevant studies using PubMed, Scopus and Embase databases. The search was limited to human studies published in English up to and including December 2015. Only studies among women with early stage breast cancer treated with chemotherapy, with reported body weight before and after chemotherapy and type of chemotherapy were included. Random-effect models were used, and heterogeneity between studies was explored through stratified analyses and meta-regression. Sensitivity analyses were done to explore whether a specific study markedly affected the results. Results: In total 25 papers were found, including data from 2620 women. Overall, body weight increased during chemotherapy: 2.7 kg (95% CI 2.0, 7.5) with a high degree of heterogeneity (I 2 = 94.2%). Stratified analyses showed weight gain in all strata, but did not substantially reduce heterogeneity. Univariate meta-regression showed less weight gain in prospective studies compared to chart review studies (-2.0, 95% CI: -3.1, -0.8). Studies including cyclophosphamide, methotrexate and 5-fluorouracil (CMF) regimes showed a greater weight gain compared to those that did not (2.2, 95% CI: 1.1, 3.3); and papers published until the year 2000 showed a greater weight gain compared to those published after 2000 (1.9, 95% CI:-0.8, 3.1). In the multivariate models only studies including CMF regimes and studies published until 2000 were associated with significant weight gain of respectively 1.3 and 1.4 kg. Conclusion: Despite the high heterogeneity, this meta-analysis shows significant weight gain during chemotherapy for women with breast cancer. Weight gain was more pronounced in papers published until 2000 and women receiving CMF as chemotherapy regime. Although weight gain after chemotherapy has decreased over the course of time, weight gain is still substantial and deserves clinical attention.

Original languageEnglish (US)
Article number259
JournalBMC Cancer
Volume17
Issue number1
DOIs
StatePublished - Apr 12 2017

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Meta-Analysis
Weight Gain
Breast Neoplasms
Weights and Measures
Drug Therapy
Methotrexate
Fluorouracil
Cyclophosphamide
Body Weight
Body Weight Changes
PubMed
Sample Size
Regression Analysis
Databases
Prospective Studies

All Science Journal Classification (ASJC) codes

  • Oncology
  • Genetics
  • Cancer Research

Cite this

Berg, M. M. G. A., Winkels, R., Kruif, J. T. C. M., Laarhoven, H. W. M., Visser, M., Vries, J. H. M., ... Kampman, E. (2017). Weight change during chemotherapy in breast cancer patients: A meta-analysis. BMC Cancer, 17(1), [259]. https://doi.org/10.1186/s12885-017-3242-4
Berg, M. M.G.A. ; Winkels, Renate ; Kruif, J. Th C.M. ; Laarhoven, H. W.M. ; Visser, M. ; Vries, J. H.M. ; Vries, Y. C. ; Kampman, E. / Weight change during chemotherapy in breast cancer patients : A meta-analysis. In: BMC Cancer. 2017 ; Vol. 17, No. 1.
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abstract = "Background: Weight gain during chemotherapy in women with breast cancer is commonly reported. However, there are important differences between studies that examined weight change during chemotherapy; e.g. type of chemotherapy, menopausal status, time between body weight measurements and sample size. The purpose of this meta-analysis was to quantify changes in body weight during chemotherapy for women with breast cancer, taking these differences into account. Methods: We identified relevant studies using PubMed, Scopus and Embase databases. The search was limited to human studies published in English up to and including December 2015. Only studies among women with early stage breast cancer treated with chemotherapy, with reported body weight before and after chemotherapy and type of chemotherapy were included. Random-effect models were used, and heterogeneity between studies was explored through stratified analyses and meta-regression. Sensitivity analyses were done to explore whether a specific study markedly affected the results. Results: In total 25 papers were found, including data from 2620 women. Overall, body weight increased during chemotherapy: 2.7 kg (95{\%} CI 2.0, 7.5) with a high degree of heterogeneity (I 2 = 94.2{\%}). Stratified analyses showed weight gain in all strata, but did not substantially reduce heterogeneity. Univariate meta-regression showed less weight gain in prospective studies compared to chart review studies (-2.0, 95{\%} CI: -3.1, -0.8). Studies including cyclophosphamide, methotrexate and 5-fluorouracil (CMF) regimes showed a greater weight gain compared to those that did not (2.2, 95{\%} CI: 1.1, 3.3); and papers published until the year 2000 showed a greater weight gain compared to those published after 2000 (1.9, 95{\%} CI:-0.8, 3.1). In the multivariate models only studies including CMF regimes and studies published until 2000 were associated with significant weight gain of respectively 1.3 and 1.4 kg. Conclusion: Despite the high heterogeneity, this meta-analysis shows significant weight gain during chemotherapy for women with breast cancer. Weight gain was more pronounced in papers published until 2000 and women receiving CMF as chemotherapy regime. Although weight gain after chemotherapy has decreased over the course of time, weight gain is still substantial and deserves clinical attention.",
author = "Berg, {M. M.G.A.} and Renate Winkels and Kruif, {J. Th C.M.} and Laarhoven, {H. W.M.} and M. Visser and Vries, {J. H.M.} and Vries, {Y. C.} and E. Kampman",
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Berg, MMGA, Winkels, R, Kruif, JTCM, Laarhoven, HWM, Visser, M, Vries, JHM, Vries, YC & Kampman, E 2017, 'Weight change during chemotherapy in breast cancer patients: A meta-analysis', BMC Cancer, vol. 17, no. 1, 259. https://doi.org/10.1186/s12885-017-3242-4

Weight change during chemotherapy in breast cancer patients : A meta-analysis. / Berg, M. M.G.A.; Winkels, Renate; Kruif, J. Th C.M.; Laarhoven, H. W.M.; Visser, M.; Vries, J. H.M.; Vries, Y. C.; Kampman, E.

In: BMC Cancer, Vol. 17, No. 1, 259, 12.04.2017.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Weight change during chemotherapy in breast cancer patients

T2 - A meta-analysis

AU - Berg, M. M.G.A.

AU - Winkels, Renate

AU - Kruif, J. Th C.M.

AU - Laarhoven, H. W.M.

AU - Visser, M.

AU - Vries, J. H.M.

AU - Vries, Y. C.

AU - Kampman, E.

PY - 2017/4/12

Y1 - 2017/4/12

N2 - Background: Weight gain during chemotherapy in women with breast cancer is commonly reported. However, there are important differences between studies that examined weight change during chemotherapy; e.g. type of chemotherapy, menopausal status, time between body weight measurements and sample size. The purpose of this meta-analysis was to quantify changes in body weight during chemotherapy for women with breast cancer, taking these differences into account. Methods: We identified relevant studies using PubMed, Scopus and Embase databases. The search was limited to human studies published in English up to and including December 2015. Only studies among women with early stage breast cancer treated with chemotherapy, with reported body weight before and after chemotherapy and type of chemotherapy were included. Random-effect models were used, and heterogeneity between studies was explored through stratified analyses and meta-regression. Sensitivity analyses were done to explore whether a specific study markedly affected the results. Results: In total 25 papers were found, including data from 2620 women. Overall, body weight increased during chemotherapy: 2.7 kg (95% CI 2.0, 7.5) with a high degree of heterogeneity (I 2 = 94.2%). Stratified analyses showed weight gain in all strata, but did not substantially reduce heterogeneity. Univariate meta-regression showed less weight gain in prospective studies compared to chart review studies (-2.0, 95% CI: -3.1, -0.8). Studies including cyclophosphamide, methotrexate and 5-fluorouracil (CMF) regimes showed a greater weight gain compared to those that did not (2.2, 95% CI: 1.1, 3.3); and papers published until the year 2000 showed a greater weight gain compared to those published after 2000 (1.9, 95% CI:-0.8, 3.1). In the multivariate models only studies including CMF regimes and studies published until 2000 were associated with significant weight gain of respectively 1.3 and 1.4 kg. Conclusion: Despite the high heterogeneity, this meta-analysis shows significant weight gain during chemotherapy for women with breast cancer. Weight gain was more pronounced in papers published until 2000 and women receiving CMF as chemotherapy regime. Although weight gain after chemotherapy has decreased over the course of time, weight gain is still substantial and deserves clinical attention.

AB - Background: Weight gain during chemotherapy in women with breast cancer is commonly reported. However, there are important differences between studies that examined weight change during chemotherapy; e.g. type of chemotherapy, menopausal status, time between body weight measurements and sample size. The purpose of this meta-analysis was to quantify changes in body weight during chemotherapy for women with breast cancer, taking these differences into account. Methods: We identified relevant studies using PubMed, Scopus and Embase databases. The search was limited to human studies published in English up to and including December 2015. Only studies among women with early stage breast cancer treated with chemotherapy, with reported body weight before and after chemotherapy and type of chemotherapy were included. Random-effect models were used, and heterogeneity between studies was explored through stratified analyses and meta-regression. Sensitivity analyses were done to explore whether a specific study markedly affected the results. Results: In total 25 papers were found, including data from 2620 women. Overall, body weight increased during chemotherapy: 2.7 kg (95% CI 2.0, 7.5) with a high degree of heterogeneity (I 2 = 94.2%). Stratified analyses showed weight gain in all strata, but did not substantially reduce heterogeneity. Univariate meta-regression showed less weight gain in prospective studies compared to chart review studies (-2.0, 95% CI: -3.1, -0.8). Studies including cyclophosphamide, methotrexate and 5-fluorouracil (CMF) regimes showed a greater weight gain compared to those that did not (2.2, 95% CI: 1.1, 3.3); and papers published until the year 2000 showed a greater weight gain compared to those published after 2000 (1.9, 95% CI:-0.8, 3.1). In the multivariate models only studies including CMF regimes and studies published until 2000 were associated with significant weight gain of respectively 1.3 and 1.4 kg. Conclusion: Despite the high heterogeneity, this meta-analysis shows significant weight gain during chemotherapy for women with breast cancer. Weight gain was more pronounced in papers published until 2000 and women receiving CMF as chemotherapy regime. Although weight gain after chemotherapy has decreased over the course of time, weight gain is still substantial and deserves clinical attention.

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Berg MMGA, Winkels R, Kruif JTCM, Laarhoven HWM, Visser M, Vries JHM et al. Weight change during chemotherapy in breast cancer patients: A meta-analysis. BMC Cancer. 2017 Apr 12;17(1). 259. https://doi.org/10.1186/s12885-017-3242-4