Gupta Digant, Lis Christopher G, Granick Joel, Grutsch James F, Vashi Pankaj G, Lammersfeld Carolyn A
Cancer Treatment Centers of America at Midwestern Regional Medical Center, Operations Center, Office of Research, 2610 Sheridan Road, Zion, IL 60099, USA.
J Clin Epidemiol. 2006 Jul;59(7):704-9. doi: 10.1016/j.jclinepi.2005.08.020. Epub 2006 Apr 19.
Malnutrition is a significant cause of morbidity and mortality in advanced colorectal cancer, and little is known about its relationship with quality of life (QoL). We investigated the relationship between nutritional status and QoL in colorectal cancer.
We examined a case series of 58 stage III-IV colorectal cancer patients treated at Cancer Treatment Centers of America. Nutritional status was evaluated using laboratory measures of serum albumin, prealbumin, and transferrin, subjective global assessment (SGA) and bioelectrical impedance analysis. QoL was evaluated using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (QLQ-C30).
The prevalence of malnutrition, as determined by SGA, was 41% (24 of 58). Well-nourished patients had statistically significantly better QoL scores on the global, physical, and role functions compared to malnourished patients. Interestingly, the median role function score in well-nourished patients was 41.6 points higher than the corresponding score in malnourished patients, indicating a "much better" functioning from a patient's perspective. Similarly, QoL scores on multiple symptom scales were statistically significantly better among well-nourished patients.
This study suggests that malnutrition is associated with poor QoL, as measured by the QLQ-C30 in colorectal cancer.
营养不良是晚期结直肠癌发病和死亡的重要原因,而关于其与生活质量(QoL)的关系知之甚少。我们研究了结直肠癌患者营养状况与生活质量之间的关系。
我们对在美国癌症治疗中心接受治疗的58例III-IV期结直肠癌患者的病例系列进行了研究。使用血清白蛋白、前白蛋白和转铁蛋白的实验室检测指标、主观全面评定法(SGA)以及生物电阻抗分析来评估营养状况。使用欧洲癌症研究与治疗组织生活质量问卷核心30项(QLQ-C30)来评估生活质量。
根据SGA确定的营养不良患病率为41%(58例中的24例)。与营养不良患者相比,营养良好的患者在总体、身体和角色功能方面的生活质量得分在统计学上显著更高。有趣的是,营养良好患者的角色功能得分中位数比营养不良患者的相应得分高41.6分,从患者角度表明功能“好得多”。同样,营养良好患者在多个症状量表上的生活质量得分在统计学上也显著更好。
本研究表明,以结直肠癌患者的QLQ-C30衡量营养不良与生活质量差有关。