Davidson Wendy, Ash Susan, Capra Sandra, Bauer Judith
Nutrition and Dietetic Services, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Brisbane 4102, Australia.
Clin Nutr. 2004 Apr;23(2):239-47. doi: 10.1016/j.clnu.2003.07.001.
BACKGROUND & AIMS: Cancer-induced weight loss is associated with poor outcomes and is common in pancreatic cancer. The aims were to determine whether stabilising weight loss for patients with unresectable pancreatic cancer was associated with improved survival and quality of life (QoL) and to identify determinants of weight stabilisation.
A post hoc analysis was performed using data from 107 patients in a multicentre trial. Patients were categorised as weight losing (> 1 kg lost) or weight stable (< or = 1 kg lost) after an 8 week nutrition intervention period. Group survival duration (Kaplan Meier) and QoL (EORTC QLQ-C30) were compared. Predictors of weight stability were determined using logistic regression analysis.
Patients with weight stabilisation survived longer from baseline (log rank test 5.53, P = 0.019). They also reported higher QoL scores (P = 0.037) and a greater mean energy intake (P <0.001) at Week 8 than those who continued to lose weight. The absence of nausea and vomiting (OR 6.5, P =0.010) and female gender (OR 5.2, P = 0.020) were independent determinants of weight stabilisation.
Weight stabilisation over an 8 week period in weight-losing patients with unresectable pancreatic cancer was associated with improved survival duration and QoL.
癌症导致的体重减轻与不良预后相关，在胰腺癌中很常见。本研究旨在确定不可切除胰腺癌患者体重减轻稳定是否与生存期和生活质量（QoL）改善相关，并确定体重稳定的决定因素。
使用一项多中心试验中107例患者的数据进行事后分析。在8周营养干预期后，将患者分为体重减轻组（体重减轻>1kg）或体重稳定组（体重减轻≤1kg）。比较两组的生存时间（Kaplan Meier法）和生活质量（EORTC QLQ-C30量表）。采用逻辑回归分析确定体重稳定的预测因素。
体重稳定的患者从基线开始的生存期更长（对数秩检验5.53，P = 0.019）。与继续体重减轻的患者相比，他们在第8周时的生活质量评分更高（P = 0.037），平均能量摄入量也更高（P <0.001）。无恶心呕吐（比值比6.5，P = 0.010）和女性（比值比5.2，P = 0.020）是体重稳定的独立决定因素。
不可切除胰腺癌体重减轻患者在8周内实现体重稳定与生存期和生活质量改善相关。
