Lee Haidy, Havrila Carole, Bravo Vikki, Shantz Kellie, Diaz Kellie, Larner James, Read Paul
Department of Radiation Oncology, University of Virginia Medical Center, Charlottesville, VA 22908-800383, USA.
Support Care Cancer. 2008 Mar;16(3):285-9. doi: 10.1007/s00520-007-0313-0. Epub 2007 Aug 7.
Malnutrition in the head and neck cancer population is a widely recognized factor contributing to negative outcomes. The goal of this study was to determine if providing complimentary oral nutritional supplementation for patients undergoing definitive radiation therapy for oropharyngeal carcinoma reduced weight loss and the need for percutaneous endoscopic gastrostomy (PEG) tube placement.
The data from 79 patients undergoing radiotherapy for oropharyngeal cancer were extracted and analyzed retrospectively from an institutional Human Investigation Committee approved database for the study of advanced radiation therapy techniques for head and neck cancer. Forty patients were treated before the initiation of a nutritional supplementation program, and 39 patients received supplementation. Patients were stratified by type of treatment (radiation alone or chemoradiation) and whether or not they had a PEG tube.
All patient groups receiving supplementation manifested a significant decrease in weight loss compared to those who did not receive it. Nutritional supplementation was associated with a 40% relative reduction in weight loss in patients treated with radiotherapy alone (6.1 vs 10.1%, p = 0.008) and a 37% reduction in weight loss in patients treated with chemoradiotherapy (6.7 vs 10.7%, p = 0.007). When patients were stratified by the presence or absence of a PEG tube, both groups experienced a 39% relative reduction in weight loss (with PEG, 5.7 vs 9.3%, p = 0.028; without PEG, 6.9 vs 11.2%, p = 0.002). Supplementation was associated with a decreased need for PEG tube placement (31% decreased to 6%) in patients treated with radiotherapy alone.
Providing complimentary oral nutritional supplementation significantly decreases weight loss and the need for PEG tube placement in patients undergoing radiation therapy for oropharyngeal cancer.
头颈部癌症患者的营养不良是导致不良后果的一个广为人知的因素。本研究的目的是确定为接受口咽癌根治性放射治疗的患者提供补充性口服营养补充剂是否能减少体重减轻以及经皮内镜下胃造口术（PEG）置管的需求。
从一个经机构人类研究委员会批准的数据库中回顾性提取并分析了79例接受口咽癌放疗患者的数据，该数据库用于头颈部癌症的先进放射治疗技术研究。40例患者在营养补充计划启动前接受治疗，39例患者接受了补充剂。患者按治疗类型（单纯放疗或放化疗）以及是否有PEG管进行分层。
与未接受补充剂的患者相比，所有接受补充剂的患者组体重减轻均显著减少。营养补充剂使单纯放疗患者的体重减轻相对减少40%（6.1%对10.1%，p = 0.008），使放化疗患者的体重减轻相对减少37%（6.7%对10.7%，p = 0.007）。当按是否有PEG管对患者进行分层时，两组体重减轻均相对减少39%（有PEG管，5.7%对9.3%，p = 0.028；无PEG管，6.9%对11.2%，p = 0.002）。补充剂与单纯放疗患者PEG管置管需求的减少相关（从31%降至6%）。
提供补充性口服营养补充剂可显著减少接受口咽癌放射治疗患者的体重减轻以及PEG管置管的需求。
