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头颈癌患者营养不良的判定:评估工具及放射肿瘤学家的营养教育

Determination of malnourishment in the head and neck cancer patient: assessment tools and nutrition education of radiation oncologists.

作者信息

DeCicco Paul V, Wunderlich Shahla M, Emmolo Joana S

机构信息

Elite Fitness and Sports Training, 237 Millburn Avenue, Millburn, NJ 07041, USA.

出版信息

Support Care Cancer. 2011 Jan;19(1):123-30. doi: 10.1007/s00520-009-0796-y. Epub 2010 Jan 14.

Abstract

PURPOSE

The purpose of this study is to evaluate current assessment practices of malnourishment by radiation oncologists among the head and neck cancer patient population.

METHODS

A cross-sectional descriptive study was conducted. A 14-question survey was mailed to 333 radiation oncologists self-identified as "interested in the treatment of head and neck cancer."

RESULTS

About 87% of radiation oncologists indicated that they used bodyweight as the sole determinant of malnourishment in head and neck cancer patients at initial consultation. Radiation oncologists with 0 to 10 years experience were found to have a higher level of formal nutrition education than those with 11 to 20 years (p=0.0052). A significant difference was found between radiation oncologists with formal nutrition education vs. those without, in answering whether nutrition interventions play a significant role in the prognosis of such cancer patients (p=0.0013). In addition, a significant difference was noted in methods used to determine proper caloric intake when the oncologists were stratified by their beliefs about nutrition being a significant variable affecting the prognosis of head and neck cancer patients (p=0.0024).

CONCLUSION

Assessment or screening for malnourishment in the head and neck cancer patient should be a routine part of the initial consultation. Radiation oncologists and their medical team, including nutritionists, should use an appropriate nutrition screening and assessment tool in addition to the body weight as an indicator of malnourishment. Nutrition education provided to radiation oncologists should be improved to better communicate the positive effects of nutrition interventions on prognosis.

摘要

目的

本研究旨在评估放射肿瘤学家对头颈部癌症患者群体营养不良的当前评估实践。

方法

进行了一项横断面描述性研究。向333名自我认定为“对头颈部癌症治疗感兴趣”的放射肿瘤学家邮寄了一份包含14个问题的调查问卷。

结果

约87%的放射肿瘤学家表示,他们在初次会诊时将体重作为头颈部癌症患者营养不良的唯一决定因素。发现从业0至10年的放射肿瘤学家比从业11至20年的放射肿瘤学家接受正规营养教育的水平更高(p = 0.0052)。在回答营养干预是否在此类癌症患者的预后中起重要作用时,接受正规营养教育的放射肿瘤学家与未接受正规营养教育的放射肿瘤学家之间存在显著差异(p = 0.0013)。此外,当根据放射肿瘤学家对营养是影响头颈部癌症患者预后的重要变量的信念进行分层时,在确定适当热量摄入的方法上也存在显著差异(p = 0.0024)。

结论

对头颈部癌症患者的营养不良评估或筛查应作为初次会诊的常规部分。放射肿瘤学家及其医疗团队,包括营养师,除了将体重作为营养不良的指标外,还应使用适当的营养筛查和评估工具。应改进向放射肿瘤学家提供的营养教育,以更好地传达营养干预对预后的积极影响。

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