Isenring E A, Capra S, Bauer J D
School of Public Health, Queensland University of Technology, Brisbane, Australia.
Br J Cancer. 2004 Aug 2;91(3):447-52. doi: 10.1038/sj.bjc.6601962.
Malnutrition occurs frequently in patients with cancer of the gastrointestinal (GI) or head and neck area and can lead to negative outcomes. The aim of this study is to determine the impact of early and intensive nutrition intervention (NI) on body weight, body composition, nutritional status, global quality of life (QoL) and physical function compared to usual practice in oncology outpatients receiving radiotherapy to the GI or head and neck area. Outpatients commencing at least 20 fractions of radiotherapy to the GI or head and neck area were randomised to receive intensive, individualised nutrition counselling by a dietitian using a standard protocol and oral supplements if required, or the usual practice of the centre (general advice and nutrition booklet). Outcome parameters were measured at baseline and 4, 8 and 12 weeks after commencing radiotherapy using valid and reliable tools. A total of 60 patients (51 M : 9 F; mean age 61.9+/-14.0 years) were randomised to receive either NI (n=29) or usual care (UC) (n=31). The NI group had statistically smaller deteriorations in weight (P<0.001), nutritional status (P=0.020) and global QoL (P=0.009) compared with those receiving UC. Clinically, but not statistically significant differences in fat-free mass were observed between the groups (P=0.195). Early and intensive NI appears beneficial in terms of minimising weight loss, deterioration in nutritional status, global QoL and physical function in oncology outpatients receiving radiotherapy to the GI or head and neck area. Weight maintenance in this population leads to beneficial outcomes and suggests that this, rather than weight gain, may be a more appropriate aim of NI.
营养不良在胃肠道或头颈部癌症患者中经常发生,并可能导致不良后果。本研究的目的是确定与接受胃肠道或头颈部放疗的肿瘤门诊患者的常规治疗相比,早期强化营养干预(NI)对体重、身体成分、营养状况、整体生活质量(QoL)和身体功能的影响。开始接受至少20次胃肠道或头颈部放疗的门诊患者被随机分为两组,一组接受营养师使用标准方案进行的强化个体化营养咨询,并根据需要口服补充剂,另一组接受中心的常规治疗(一般建议和营养手册)。使用有效且可靠的工具在基线以及放疗开始后4周、8周和12周测量结果参数。共有60例患者(51例男性:9例女性;平均年龄61.9±14.0岁)被随机分为接受NI组(n = 29)或常规护理组(UC)(n = 31)。与接受UC的患者相比,NI组在体重(P < 0.001)、营养状况(P = 0.020)和整体QoL(P = 0.009)方面的恶化在统计学上较小。临床上,两组之间无脂肪量存在差异,但无统计学意义(P = 0.195)。对于接受胃肠道或头颈部放疗的肿瘤门诊患者,早期强化NI在减轻体重减轻、营养状况恶化、整体QoL和身体功能方面似乎是有益的。在这一人群中维持体重会带来有益的结果,这表明这可能是NI更合适的目标,而不是体重增加。