鼻咽癌患者放疗前后营养状况的前瞻性研究

目的 前瞻性评价鼻咽癌患者放疗前后的营养状况，探析营养不良的早期预测因子。方法 采集159名初诊的鼻咽癌患者放疗前后的体质量及就诊时的基本资料，分析影响其营养状况的相关因素。结果 放疗前3个月89名(56%)患者已减轻5%的体质量，放疗结束，体质量下降范围为2.1～12.6kg，平均值为6.9kg。逐步回归发现，整体健康状况、体质量指数(BMI)、N分期、失眠、放疗技术、卡式评分(KPS)、同步放化疗及疲倦与放疗期间体质量减轻密切相关。结论 鼻咽癌患者营养不良是一种普遍现象。整体健康状况、体质量指数等8个因子可以对鼻咽癌放疗期间体质量减轻起到预测作用。

Prospective study of weight loss during radiotherapy in nasopharyngeal carcinoma

Objective To measure weight loss during radiotherapy, and locate predictive factors for early malnutrition. Methods The baseline of 159 newly diagnosed nasopharyngeal carcinoma(NPC)patients were collected. Patients′ weights were measured at the initial visit and at the end of radiotherapy. A stepwise linear regression analysis was performed to find the association between the baseline and malnutrition. Results At baseline, 56% of the patients already demonstrated 5% weight loss during the previoas three months. After treatment, the median weight loss was 6.9(range, 2.1-12.6)kg. Multivariate linear regression analyses showed that 8 factors were associated with significant weight loss, including global quality of life, body mass index(BMI), N stage, insomnia, radiation techniques, Karnofsky performance score(KPS), concomitant chemoradiation and fatigue. Conclusions Severe weight loss during radiotherapy for nasopharyngeal carcinoma is common. Factors, including global quality of life and body mass index, are independent prognostic factors for weight loss.