Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
Head Neck. 2013 May;35(5):695-703. doi: 10.1002/hed.23023. Epub 2012 Jun 22.
We aimed to determine the effects of systemic inflammation and symptoms of head and neck cancer patients on dietary intake and weight in relation to mode of treatment.
In all, 38 orally fed patients had intake, weight, C-reactive protein (CRP), and symptoms prospectively assessed at baseline, post-treatment, and follow-up.
Intake/weight declined and CRP increased substantially in chemoirradiation patients (-11.4 ± 5.2 kg, -1214 kcal/day, 23.4 ± 24.9 mg/L; p < .05) versus radiotherapy patients (-3.5 ± 4.8 kg, -483 kcal/day, 8.3 ± 13.9 mg/L) during posttreatment (repeated-measures ANOVA). Multivariate generalized estimating equations modeling identified reduced swallowing capacity was a key predictor of energy intake in both treatment groups (p < .001); multiple symptoms experienced by radiotherapy/chemoirradiation patients were significant predictors of weight loss; additionally, in chemoirradiation patients, CRP was an independent predictor of weight loss (p < .001).
Treatment of symptoms and systemic inflammation are important clinical targets to manage weight loss in patients with head and neck cancer, especially those treated with chemoirradiation.
我们旨在确定全身炎症和头颈部癌症患者的症状对与治疗方式相关的饮食摄入和体重的影响。
共有 38 名经口进食的患者在基线、治疗后和随访时前瞻性评估了摄入、体重、C 反应蛋白（CRP）和症状。
与接受放疗的患者相比（-3.5 ± 4.8 kg，-483 kcal/d，8.3 ± 13.9 mg/L；p <.05），接受放化疗的患者在治疗后（重复测量方差分析）摄入/体重显著下降，CRP 显著升高（-11.4 ± 5.2 kg，-1214 kcal/d，23.4 ± 24.9 mg/L）。多变量广义估计方程模型表明，吞咽能力下降是两组患者能量摄入的关键预测因素（p <.001）；放疗/放化疗患者的多种症状是体重减轻的显著预测因素；此外，在放化疗患者中，CRP 是体重减轻的独立预测因素（p <.001）。
治疗症状和全身炎症是管理头颈部癌症患者体重减轻的重要临床目标，尤其是那些接受放化疗的患者。
