体重减轻对接受同步放化疗的头颈癌患者预后的影响。

Influence of weight loss on outcomes in patients with head and neck cancer undergoing concomitant chemoradiotherapy.

作者信息

Capuano Giorgio, Grosso Alessandra, Gentile Pier Carlo, Battista Michele, Bianciardi Federico, Di Palma Annamaria, Pavese Ida, Satta Francesco, Tosti Michela, Palladino Anna, Coiro Guido, Di Palma Mario

机构信息

Clinical Nutrition Unit, Ospedale San Pietro, Fatebenefratelli, Rome, Italy.

出版信息

Head Neck. 2008 Apr;30(4):503-8. doi: 10.1002/hed.20737.

DOI:10.1002/hed.20737

PMID:18098310

Abstract

BACKGROUND

The purpose of this study was to determine the influence of weight loss on outcome in patients with head and neck cancer undergoing concomitant chemoradiotherapy (CCRT): treatment interruption, infections, mortality, and hospital readmission rate.

METHODS

Forty patients with head and neck cancer were enrolled. All patients were counseled to follow a nutritional program during CCRT. Body weight was evaluated at baseline, at the end, and 30 days after radiochemotherapy.

RESULTS

Ninety percent of compliant patients with nutritional program maintained body weight (mean, 1 +/- 2.4 kg) and 100% of noncompliant patients continued to lose weight (mean, -9 +/- 4 kg; p < .001). A reduction greater than 20% of prediagnosis weight significantly correlated with treatment interruption (p = .003), infections (p = .002), early mortality (p = .011), hospital readmission rate (p = .001), and survival (log-rank test: z = -2.722, p = .006).

CONCLUSION

In patients with head and neck cancer undergoing CCRT, the early nutritional management reduces weight loss and improve outcome.

摘要

背景

本研究旨在确定体重减轻对头颈部癌患者同步放化疗（CCRT）结局的影响：治疗中断、感染、死亡率和住院再入院率。

方法

招募了40名头颈部癌患者。所有患者在同步放化疗期间均接受了营养计划咨询。在基线、放疗化疗结束时和结束后30天评估体重。

结果

90%遵循营养计划的患者维持了体重（平均，1±2.4千克），100%未遵循营养计划的患者继续体重减轻（平均，-9±4千克；p<0.001）。诊断前体重降低超过20%与治疗中断（p=0.003）、感染（p=0.002）、早期死亡率（p=0.011）、住院再入院率（p=0.001）和生存率显著相关（对数秩检验：z=-2.722，p=0.006）。