鼻咽癌患者放化疗期间的营养状况及其影响因素CSCD

目的探讨鼻咽癌患者放化疗期间的营养状况及其影响因素。方法回顾性分析140例初治鼻咽癌患者的临床资料,运用PG-SGA、体格测量、血液学指标、放化疗不良反应和生活质量评价,全面评估患者营养状况;采用多因素Logistic回归模型分析鼻咽癌患者营养不良的主要影响因素。结果140例患者放化疗期间,重度营养不良发生率为80.7%;95.0%的患者出现体重下降,39.3%的患者体重下降≥10%;前白蛋白在放疗2周开始出现明显下降,放疗结束后患者贫血发生率高达54.3%;总体生活质量评分逐步下降,放疗结束后仅38.9分。临床分期、治疗期间体重下降、前白蛋白、贫血、口腔黏膜炎、总体生活质量、经济困难是鼻咽癌患者营养不良的影响因素(均P<0.05)。结论鼻咽癌患者放化疗期间营养不良发生率高;临床分期、治疗期间体重下降、贫血、口腔黏膜炎、经济困难是鼻咽癌患者营养不良的独立危险因素,前白蛋白、总体生活质量是鼻咽癌患者营养不良的独立保护性因素。

Nutritional Status and Its Influencing Factors of Nasopharyngeal Carcinoma Patients During Chemoradiotherapy

Objective To analyze nutritional status and influencing factors of patients with nasopharyngeal carcinoma (NPC) during chemoradiotherapy. Methods We reviewed retrospectively the clinical data of 140 NPC patients. PG-SGA questionnaire, the anthropometry measurements, hematological indexes, sideeffects of chemoradiotherapy and quality of life were used to evaluate nutritional status of NPC patients. Multivariate Logistic regression model was used to analyze the main influence factors for malnutrition of NPC patients. Results During chemoradiotherapy, 80.7% of the NPC patients had severe malnutrition, 95.0% lost weight, 39.3% lost weight more than 10%. Prealbumin declined significantly at the 2nd week of radiotherapy, and the rate of anemia was 54.3% at the end of radiotherapy. The score of overall QOL was only 38.9 at the end of radiotherapy. Clinical stages, weight loss during  chemoradiotherapy, prealbumin, anemia, oral mucositis, overall QOL and economic status were influence factors for malnutrition of NPC patients (all P<0.05). Conclusion The incidence of malnutrition is high in NPC patients during chemoradiotherapy. Clinical stages, weight loss during chemoradiotherapy, anemia, oral mucositis and financial difficulty are the independent risk factors for the malnutrition of NPC patients. Prealbumin and overall QOL are the independent protective factors for the malnutrition of NPC patients.