Assessment of a Dietary Questionnaire in Cancer Patients Receiving Cytotoxic Chemotherapy Jeffrey A. Meyerhardt, Denise Heseltine, Hannia Campos, Michelle D. Holmes, Walter C. Willett, Eric P. Winer, Peter C. Enzinger, Craig A. Bunnell, Matthew H. Kulke, and Charles S. Fuchs A B S T R A C T Purpose Few studies have examined the inﬂuence of diet on survival and chemotherapy-associated toxicities in patients with cancer. Although several comprehensive dietary questionnaires have been validated and calibrated in healthy populations, similar studies have not been performed among cancer patients. Methods Two hundred patients with colorectal, breast, or neuroendocrine cancer undergoing treat- ment with cytotoxic chemotherapy completed a self-administered, 131-item, semiquantita- tive food frequency questionnaire. Using the questionnaire, we calculated dietary intakes of carotenoids, tocopherols, and fatty acids, and correlated these values with relevant biomar- kers measured in simultaneously collected plasma specimens. Results The Pearson correlation coefﬁcients for various carotenoids as measured by the question- naire, with the corresponding measurements in plasma specimens, ranged from 0.33 to 0.44 (all P  .001), adjusted for total energy intake, body mass index, age, sex, smoking status, and total plasma cholesterol. Similarly, the adjusted correlation between self-reported total vitamin E intake and plasma alpha-tocopherol was 0.34 (P  .001). Correlations between questionnaire and plasma measurements of trans-fat, eicosapentaenoic acid, and docosahexaenoic acid were 0.55, 0.29, and 0.42 (all P  .001), respectively. These levels of correlation are consistent with those reported in similar studies of self-reported diet in otherwise healthy populations. Conclusion Among patients with cancer receiving cytotoxic chemotherapy, questionnaire-based measure- ments of various micronutrients and dietary factors appeared to predict meaningful differences in the corresponding measurements in plasma specimens. This dietary questionnaire could offer an informative and practical means for assessing the inﬂuence of diet in cancer patients receiving chemotherapy. J Clin Oncol 23:8453-8460. © 2005 by American Society of Clinical Oncology INTRODUCTION Multiple epidemiology studies have shown a relationship between diet and the risk of developing a variety of cancers, including colorectal, breast, upper GI, and prostate. 1-6 However, data on the inﬂuence of diet on the outcomes of patients with established cancer are considerably more limited. 7 A recent panel convened by the American Cancer Society re- ported that there is insufﬁcient evidence to provide speciﬁc dietary recommendations for patients with breast, colorectal, lung, and pros- tate cancer. 7 The panel concluded that properly conducted studies of the effect of nutrition on the prognosis of cancer survivors are needed urgently, and should be a high priority for all academic and research funding agencies. To assess associations between diet and cancer risk in healthy populations, large From the Department of Medical Oncology, Dana-Farber Cancer Institute; Department of Nutrition and Epidemiol- ogy, Harvard School of Public Health; and Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, Boston, MA. Submitted April 28, 2005; accepted August 16, 2005. Supported in part by a K07 award from the National Cancer Institute (K07CA097992) and an American Soci- ety of Clinical Oncology career develop- ment award (J.A.M.). Authors’ disclosures of potential con- ﬂicts of interest are found at the end of this article. Address reprint requests to: Jeffrey A. Meyerhardt, MD, MPH, Dana-Farber Cancer Institute, 44 Binney St, Boston, MA 02115; e-mail: jmeyerhardt@ partners.org. © 2005 by American Society of Clinical Oncology 0732-183X/05/2333-8453/$20.00 DOI: 10.1200/JCO.2005.02.5460 JOURNAL OF CLINICAL ONCOLOGY O R I G I N A L R E P O R T VOLUME 23  NUMBER 33  NOVEMBER 20 2005 8453 Downloaded from jco.ascopubs.org on May 8, 2016. For personal use only. No other uses without permission. Copyright © 2005 American Society of Clinical Oncology. All rights reserved.