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BACKGROUND: Many patients with small cell lung cancer are reported to lose weight, but the mechanism of this effect is unclear. PATIENTS AND METHODS: Measurements of resting energy expenditure (REE), using indirect calorimetry and body composition (fat, fat-free mass and organ mass), using dual energy X-ray absorptiometry (DXA) and abdominal CT scans were measured in 38 patients with newly-diagnosed small cell lung cancer. Twenty-eight patients were restudied at the end of treatment. RESULTS: In those who responded to treatment there was no change in body weight, but a decrease in REE of 15.7 +/- 11.7 kJ/kg fat free mass/day, whilst in the non-responders body weight decreased 4.33 +/- 5.4 kg, but REE was unchanged. CONCLUSIONS: This study provides evidence for tumour-induced hypermetabolism which is independent of changes in gross body composition, although the absolute increase is small, approximately 0.8 MJ/day. However since body weight was maintained in those patients who responded to treatment either total energy expenditure was decreased, implying decreases in physical activity, or energy intake was increased.


Journal article


Ann Oncol

Publication Date





915 - 919


Absorptiometry, Photon, Aged, Antineoplastic Combined Chemotherapy Protocols, Body Composition, Body Weight, Carcinoma, Small Cell, Cohort Studies, Energy Metabolism, Female, Humans, Lung Neoplasms, Male, Middle Aged, Rest, Tomography, X-Ray Computed