Gonçalves Dias M C, de Fátima Nunes Marucci M, Nadalin W, Waitzberg D L
Serviço de Atendimento Ambulatorial do Instituto Central do Hospital das Clínicas da FMUSP, Brazil.
Nutr Hosp. 2005 Sep-Oct;20(5):320-5.
Malnutrition is commonly associated with head and neck cancer, due especially to anorexia, which is aggravated by radiotherapy. The objective of this study was to evaluate modifications to nutritional ingestion following three types of nutritional intervention. Sixty-four male out-patients (62.1 +/- 1.5 years) were divided into three groups: oral group, (n=32) that received an adapted oral diet; feeding tube group, (n=16) under home enteral nutrition via a nasoenteral feeding tube (6x/day); and supplement group, (n=16) with oral diet associated to oral alimentary supplement between meals (3x/day). The groups were homogeneous and counseled to maintain a caloric ingestion of 40 kcal/kg. The diet for the oral group was adapted to the age and to the side effects of radiotherapyThe nutritional state of the three groups was evaluated for the caloric-proteic ingestion, anthropometric indicators (body weight, body mass index, triceps skinfold thickness, midarm muscle area), laboratorial indicators (total proteins, albumin, hematocrit, hemoglobin and total lymphocytes count), The results showed that all of the groups presented an increase in the ingestion of calories and proteins (p < 0.001). The nutritional therapy support for patients with head and neck cancer under radiotherapy, whether exclusive oral diet, enteral through a feeding tube, or with alimentary supplement associated to an oral diet achieved a significant increase in the total caloric ingestion. It is recommended that programs be implemented-to improve the ingestion of foods among these patients.
营养不良通常与头颈癌相关，尤其是由于厌食，而放疗会加重厌食症状。本研究的目的是评估三种营养干预方式后营养摄入的变化。64名男性门诊患者（62.1±1.5岁）被分为三组：口服组（n=32），接受调整后的口服饮食；饲管组（n=16），通过鼻肠饲管进行家庭肠内营养（每天6次）；补充剂组（n=16），在两餐之间口服饮食并搭配口服营养补充剂（每天3次）。各组情况均一，并建议保持40千卡/千克的热量摄入。口服组的饮食根据年龄和放疗副作用进行了调整。对三组的营养状况进行了热量-蛋白质摄入、人体测量指标（体重、体重指数、三头肌皮褶厚度、上臂肌肉面积）、实验室指标（总蛋白、白蛋白、血细胞比容、血红蛋白和淋巴细胞总数）的评估。结果显示，所有组的热量和蛋白质摄入量均有所增加（p<0.001）。对头颈癌放疗患者的营养治疗支持，无论是单纯口服饮食、通过饲管进行肠内营养，还是口服饮食搭配营养补充剂，都能使总热量摄入显著增加。建议实施相关项目以改善这些患者的食物摄入情况。
