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[强化营养治疗对Ⅲ期和Ⅳ期头颈癌患者营养状况的影响]

[Effect of an intensive nutritional treatment in nutritional status of head and neck cancer patients in stages III and IV].

作者信息

Fuchs V, Barbosa V, Mendoza J, Vargas A, Amancio O, Hernández-Cuéllar A, Arana-Rivera E

机构信息

Servicio de Oncología, Hospital General de México, México.

出版信息

Nutr Hosp. 2008 Mar-Apr;23(2):134-40.

Abstract

OBJECTIVE

Malnutrition and accelerated weight loss are frequent secondary diagnosis in patients with cancer. Head and neck cancer (H & N Cancer) affects nutritional status because of the tumor type and localization. The aim of the study was to assess the effect of an intensive nutritional treatment (INT) on nutritional status of H & N cancer patients, stages III and IV and to compare that with a historical control whose nutritional treatment was conventional (CT).

METHODS

All patients were nutritionally assessed before oncological treatment started (anthropometrical, biochemical, and dietetically). A nutritional feeding plan according to their nutritional personal need was calculated. In case it was impossible to cover all the nutritional requirements orally, a feeding tube was placed. Nutritional follow up was performed each 21 days, during their oncological treatment in four occasions. The results obtained were compared with those obtained from the patients who received the CT that consisted only in nutritional counseling by the attending physician; the statistical test used was Mann Whitney U test.

RESULTS

The INT was associated with maintenance of the nutritional status along their oncological treatment. The statistical significant parameters were: weight 55 to 47 kg in the CT group vs 59 a 58 kg in the INT group (p < 0.0001), and hemoglobin: from 13 to 11 g/dl in the CT group vs 14 to 13 g/dl in the INT group (p < 0.002) as the most important ones. In the rest of the data we can observe a clear tendency of increasing the nutrition parameters in patients the INT group, while in the CT group, they showed a persistent decrease.

CONCLUSION

We concluded that patients who received the INT as part of their oncological treatment deteriorated less their nutritional status than those who received a CT.

摘要

目的

营养不良和体重加速下降是癌症患者常见的次要诊断。头颈癌(H & N癌)因其肿瘤类型和位置会影响营养状况。本研究的目的是评估强化营养治疗(INT)对III期和IV期H & N癌患者营养状况的影响,并将其与营养治疗为传统治疗(CT)的历史对照组进行比较。

方法

所有患者在肿瘤治疗开始前进行营养评估(人体测量、生化和饮食方面)。根据他们个人的营养需求计算营养喂养计划。如果无法通过口服满足所有营养需求,则放置喂养管。在他们接受肿瘤治疗期间,每21天进行一次营养随访,共进行四次。将获得的结果与仅由主治医生进行营养咨询的接受CT治疗的患者的结果进行比较;使用的统计检验是曼-惠特尼U检验。

结果

INT与患者在肿瘤治疗期间营养状况的维持相关。具有统计学意义的参数为:CT组体重从55降至47 kg,而INT组体重从59降至58 kg(p < 0.0001),以及血红蛋白:CT组从13降至11 g/dl,而INT组从14降至13 g/dl(p < 0.002),这些是最重要的参数。在其余数据中,我们可以观察到INT组患者的营养参数有明显上升趋势,而CT组则持续下降。

结论

我们得出结论,接受INT作为肿瘤治疗一部分的患者,其营养状况的恶化程度低于接受CT治疗的患者。

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