Abstract:Objective To investigate the correlation between nutritional status and quality of life in esophageal tumors and head and neck tumors during intensity-modulated radiotherapy. Methods The cancer patients who received radiotherapy from November 2018 to May 2019 were selected for the study. NRS 2002 and PG-SGA were used to evaluate the nutrition of the patients during radiotherapy, and EORTC QLQ-C30 was used to evaluate the quality of life, and the correlation between them was analyzed. ResultsA total of 41 patients were enrolled, including 23 cases of esophageal cancer and 18 cases of head and neck cancer. 35 cases (85.36%) lost weight after radiotherapy, of which 19 cases (46.34%) lost ≥ 5% body weight. There were 2 patients with weight loss>10%, accounting for 4.88%, and the average weight loss was 3.6kg. During radiotherapy, there were 31 patients with myelosuppression, 15 patients with hypoalbuminemia and 24 patients with electrolyte disorder. After radiotherapy, The scores of general health status and physical function of patients were lower than those before radiotherapy (P<0.05). The scores of pain, fatigue and loss of appetite were higher than those before radiotherapy (P<0.05). General health status, physical function, pain and loss of appetite were significantly correlated with nutritional status (P<0.05), while social function, emotional function, shortness of breath, constipation showed no significant correlation with nutritional status (P>0.05). ConclusionThe nutritional status of cancer patients during radiotherapy is correlated with their quality of life. Attention should be paid to the nutritional evaluation and intervention during radiotherapy, in order to improve the quality of life in terms of physical function, pain and appetite and efficacy of cancer patients.
梁岚青, 罗燕容, 王倩倩, 马林, 曲宝林, 刘芳. 调强放疗的肿瘤患者营养状况与生活质量相关性分析[J]. 肿瘤代谢与营养电子杂志, 2019, 6(4): 482-487.
LIANG Lan-qing, LUO Yan-rong, WANG Qian-qian, MA Lin, QU Bao-lin, LIU Fang . Correlation between nutritional status and quality of life during intensity-modulated radiotherapy in cancer patients. Electron J Metab Nutr Cancer, 2019, 6(4): 482-487.
1.赫捷, 王绿化, 李晔雄, 等. 放射治疗质量控制基本指南. 上海医学. 2018;41(10):577-583.
2.Zhao N, Yang R, Jiang Y, et al. A hybrid IMRT/VMAT technique for the treatment of nasopharyngeal cancer. Biomed Res Int. 2015;2015:940102.
3.Zhang Z, Zhu Y, Ling Y, et al. Comparative effects of different enteral feeding methods in head and neck cancer patients receiving radiotherapy or chemoradiotherapy: a network meta-analysis. Onco Targets Ther. 2016;9:2897-2909.
4.Ma L, Luo GY, Ren YF, et al. Concurrent chemoradiotherapy combined with enteral nutrition support: a radical treatment strategy for esophageal squamous cell carcinoma patients with malignant fistulae. Chin J Cancer. 2017;36(1):8.
5.Arends J, Baracos V, Bertz H, et al. ESPEN expert group recommendations for action against cancer-related malnutrition. Clin Nutr. 2017;36(5):1187-1196.
6.李涛, 吕家华, 郎锦义, 等. 恶性肿瘤放疗患者营养治疗专家共识. 肿瘤代谢与营养电子杂志. 2018;5(4):358-365.
7.Kondrup J, Rasmussen HH, Hamberg O, et al. Nutritional risk screening (NRS 2002):A new method based on an analysis of controlled clinical trials. Clin Nutr. 2003;22(3):321-336.
8.Zhou X, Qiu GQ, Bao WA, et al. The prognostic role of nutrition risk score (NRS) in patients with metastatic or recurrent esophageal squamous cell carcinoma (ESCC). Oncotarget. 2017;8(44):77465-77473.
9.Peng H, Chen BB, Tang LL, et al. Prognostic value of nutritional risk screening 2002 scale in nasopharyngeal carcinoma: a large-scale cohort study. Cancer Sci. 2018;109(6):1909-1919.
10.Bauer J, Capra S, Ferguson M, et al. Use of the scored patient-generated subjective global assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. Eur J Clin Nutr. 2002;56(8):779-785.
11.Hofto S, Abbott J, Jackson JE, et al. Investigating adherence to Australian nutritional care guidelines in patients with head and neck cancer. Cancers Head Neck. 2018;2018:3-6.
12.石英英, 张晓伟, 袁凯涛,等. PG-SGA操作标准介绍. 中华肿瘤防治杂志. 2013;20(22):1779-1782.
13.石汉平. 营养治疗的疗效评价. 肿瘤代谢与营养电子杂志. 2017;4(4):364-370.
14.Liao LJ, Hsu WL, Lo WC, et al. Health-related quality of life and utility in head and neck cancer survivors. BMC Cancer. 2019;19(1):425.
15.Degboe A, Knight SL, Halling K, et al. Patients experience of recurrent/metastatic head and neck squamous cell carcinoma and their perspective on the EORTC QLQ-C30 and QLQ-H&N35 questionnaires: a qualitative study. J Patient Rep Outcomes. 2017;2:33.
16.Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin. 2016;66(2):115-132.
17.Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424.
18.李增宁, 陈伟, 齐玉梅, 等. 恶性肿瘤患者膳食营养处方专家共识. 肿瘤代谢与营养电子杂志. 2017;4(4):397-408.
19.Cereda E, Cappello S, Colombo S, et al. Nutritional counseling with or without systematic use of oral nutritional supplements in head and neck cancer patients undergoing radiotherapy. Radiother Oncol. 2018;126(1):81-88.
20.Alhambra Exposito MR, Herrera-Martinez AD, Manzano Garcia G, et al. Early nutrition support therapy in patients with head-neck cancer. Nutr Hosp. 2018;35(3):505-510.
21.卢晓旭, 吴慧, 孙学明,等. 头颈部肿瘤患者放疗期间营养状况的变化及其对放疗不良反应的影响. 医药论坛杂志. 2016;37(1):124-125.
22.Shen LJ, Chen C, Li BF, et al. High weight loss during radiation treatment changes the prognosis in under-/normal weight nasopharyngeal carcinoma patients for the worse: a retrospective analysis of 2433 cases. PLoS One. 2013;8(7):e68660.
23.Sakanaka K, Fujii K, Ishida Y, et al. Nutritional and clinical outcomes of chemoradiotherapy for clinical T1N0M0 esophageal carcinoma. Cancer Manag Res. 2019;11:3623-3630.
24.Bozzetti F, Mariani L, Lo Vullo S, et al. The nutritional risk in oncology: a study of 1,453 cancer outpatients. Support Care Cancer. 2012;20(8):1919-1928.
25.Zhu Y, Wang L, Yang Z, et al. Hematopoietic effects of paeoniflorin and albiflorin on radiotherapy-induced myelosuppression mice. Evid Based Complement Alternat Med. 2016;2016:5789381.
26.任杰, 袁志, 张欣平, 等. 头颈部肿瘤患者放疗期间营养状况与生活质量现状及二者相关性分析. 解放军医药杂志. 2018;30(7):18-21.
27.Sandmael JA, Bye A, Solheim TS, et al. Feasibility and preliminary effects of resistance training and nutritional suppl ements during versus after radiotherapy in patients with head and neck cancer: a pilot randomized trial. Cancer. 2017;123(22):4440-4448.
28.石汉平. 恶性肿瘤病人营养诊断及实施流程. 中国实用外科杂志. 2018;38(3):257-261.
29.石汉平. 营养治疗是肿瘤的一线治疗. 临床药物治疗杂志. 2019;17(4):20-25.