Faculty of Nursing, University of Alberta, Edmonton, AB, Canada,
Support Care Cancer. 2013 Nov;21(11):3127-36. doi: 10.1007/s00520-013-1870-z. Epub 2013 Jul 14.
This study aimed to validate the Head and Neck Patient Symptom Checklist(©) (HNSC(©)) by tracing the prevalence and interference with eating of nutrition impact symptoms (NIS) over time and by examining relationships among NIS included in the HNSC, energy intake, and weight loss.
Height, weight, 3-day diet records, and HNSC(©) were obtained at baseline, posttreatment, and 2.5 month follow-up for 52 treatment-naive head and neck cancer (HNC) patients. Relationships among energy intake, weight loss, age, sex, treatment, tumor stage, and NIS were evaluated using general estimating equation (GEE) modeling. Cumulative hazard (CH) analysis was used to determine the time and risk of weight loss.
From baseline to posttreatment, 71 % of patients had 5 % body weight loss. Despite energy intakes returning to baseline levels at follow-up, 88 % of patients continued to lose weight. At posttreatment, 100 % of patients reported 2 or more NIS (range 2-12); these symptoms were still present at follow-up in 83 % of the patients. Univariate GEE analysis demonstrated that most NIS predicted energy intake and weight loss, while multivariate GEE analysis showed that depression, dysphagia, and sore mouth predicted energy intake, and dysphagia and sore mouth predicted weight loss. CH analysis showed that NIS accelerated the time and probability of weight loss.
The HNSC(©) is a valid tool for assessing NIS in HNC. Identification of NIS may aid in the management of symptoms associated with reduced energy intake and weight loss and thus decrease the malnutrition risk in HNC patients.
本研究旨在通过跟踪营养影响症状（NIS）的发生率和对进食的干扰随时间的变化，以及检查 HNSC（©）中包含的 NIS 与能量摄入和体重减轻之间的关系，来验证头颈部患者症状清单（©）（HNSC（©））。
52 例未经治疗的头颈部癌症（HNC）患者在基线、治疗后和 2.5 个月随访时获得身高、体重、3 天饮食记录和 HNSC（©）。使用一般估计方程（GEE）模型评估能量摄入、体重减轻、年龄、性别、治疗、肿瘤分期和 NIS 之间的关系。使用累积危害（CH）分析来确定体重减轻的时间和风险。
从基线到治疗后，71%的患者体重减轻了 5%。尽管在随访时能量摄入量恢复到基线水平，但 88%的患者仍在继续减重。在治疗后，100%的患者报告有 2 种或更多 NIS（范围 2-12）；在随访中，83%的患者仍存在这些症状。单变量 GEE 分析表明，大多数 NIS 预测了能量摄入和体重减轻，而多变量 GEE 分析表明，抑郁、吞咽困难和口腔疼痛预测了能量摄入，而吞咽困难和口腔疼痛预测了体重减轻。CH 分析表明，NIS 加速了体重减轻的时间和概率。
HNSC（©）是评估 HNC 中 NIS 的有效工具。识别 NIS 可能有助于管理与能量摄入减少和体重减轻相关的症状，从而降低 HNC 患者的营养不良风险。
