Munshi Anusheel, Pandey Manish Bhushan, Durga Tarun, Pandey Kailash Chander, Bahadur Sudhir, Mohanti Bidhu Kalyan
Department of Radiotherapy, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi 110029, India.
Nutr Cancer. 2003;47(2):136-40. doi: 10.1207/s15327914nc4702_5.
Radiotherapy (RT) is an important treatment modality in head and neck cancers. Loss of weight during RT due to various factors is a matter of concern. This study was conducted to see the pattern of weight loss and the causative factors involved. One hundred forty patients with head and neck cancer treated with radical RT, concurrent chemoradiation, or postoperative RT were retrospectively studied. A dose of 70 Gy was given in the radical and in the chemoradiation schedule. In postoperative RT, a dose of 60-64 Gy was delivered. During the weekly review of the patients, serial recording of their weight was done along with measurement of other parameters. Analysis was done to see which factors were causative in patients having a weight loss of >5 kg and of >10%. Three variables were found to be significant for the >5-kg weight loss. These were a low initial Karnofsky performance score (KPS; P < 0.001), use of chemoradiation (P < 0.001), and a total dose of >60 Gy (P = 0.04). For the >10% weight loss, the significant factors were low initial KPS (P < 0.001) and use of chemoradiation (P < 0.001). Therefore, it is important to take care of the nutrition of those patients who have a low KPS, are on chemoradiation, or will be delivered a dose of >60 Gy. The role of prophylactic Ryle's tube placement or agents such as megestrol acetate in such patients should be further investigated.
放射治疗（RT）是头颈癌的一种重要治疗方式。由于各种因素，放疗期间体重减轻是一个值得关注的问题。本研究旨在观察体重减轻的模式以及相关的致病因素。对140例接受根治性放疗、同步放化疗或术后放疗的头颈癌患者进行了回顾性研究。根治性放疗和同步放化疗方案给予的剂量为70 Gy。术后放疗给予的剂量为60 - 64 Gy。在每周对患者进行复查时，除测量其他参数外，还对其体重进行了连续记录。进行分析以确定哪些因素导致体重减轻超过5 kg和超过10%的患者出现体重减轻。发现三个变量对于体重减轻超过5 kg具有显著意义。这些变量包括初始卡诺夫斯基表现评分（KPS）较低（P < 0.001）、采用同步放化疗（P < 0.001）以及总剂量超过60 Gy（P = 0.04）。对于体重减轻超过10%的情况，显著因素是初始KPS较低（P < 0.001）和采用同步放化疗（P < 0.001）。因此，对于KPS较低、接受同步放化疗或总剂量将超过60 Gy的患者，关注其营养状况非常重要。此类患者预防性放置鼻胃管或使用醋酸甲地孕酮等药物的作用应进一步研究。
