Hopanci Bicakli D, Ozkaya Akagunduz O, Meseri Dalak R, Esassolak M, Uslu R, Uyar M
Department of Medical Oncology, Ege University School of Medicine, Bornova, 35100 Izmir, Turkey.
Department of Radiation Oncology, Ege University School of Medicine, Bornova, 35100 Izmir, Turkey.
J Nutr Metab. 2017;2017:8631945. doi: 10.1155/2017/8631945. Epub 2017 Jan 1.
. Radiotherapy (RT) has been associated with increased risk of malnutrition in cancer patients, particularly in those with head and neck cancer (HNC). The aim of this prospective study was to evaluate the effects of compliance of patients with individual dietary counselling on body composition parameters in HNC patients under RT. . Sixty-nine consecutive patients (mean age: 61.0 ± 13.8) were prospectively followed. Bioelectrical impedance analysis (BIA) was performed to determine body composition parameters before, in the middle of, and at the end of RT. All patients received nutritional counselling and majority of them (94.6%) received oral nutritional supplement (ONS) during RT or chemoradiotherapy. If a patient consumed ≥75% of the recommended energy and protein intake via ONS and regular food, he/she was considered to be "compliant" ( = 18), while those who failed to meet this criteria were considered to be "noncompliant" ( = 30). . Body mass index, weight, fat percentage, fat mass, fat free mass, and muscle mass did not decrease significantly over time in compliant patients, but in noncompliant patients, all of these indices decreased significantly from baseline compared to the end of treatment ( < 0.001). Hand grip strength did not differ significantly between the two groups at baseline and over time in each group. When retrospectively evaluated, heavy mucositis was less commonly observed in compliant than noncompliant patients (11.1% versus 88.9%, resp.) ( < 0.009). . We conclude that body composition parameters were better in head and neck cancer patients considered as compliant with nutritional counselling than noncompliant ones during RT period.
放疗（RT）与癌症患者营养不良风险增加有关，尤其是头颈部癌（HNC）患者。这项前瞻性研究的目的是评估HNC患者在放疗期间接受个体化饮食咨询的依从性对身体成分参数的影响。
前瞻性地跟踪了69例连续患者（平均年龄：61.0±13.8岁）。在放疗前、放疗中期和放疗结束时进行生物电阻抗分析（BIA）以确定身体成分参数。所有患者均接受营养咨询，并且大多数患者（94.6%）在放疗或放化疗期间接受了口服营养补充剂（ONS）。如果患者通过ONS和常规食物摄入了≥75%的推荐能量和蛋白质摄入量，则被认为是“依从的”（n = 18），而未达到该标准的患者被认为是“不依从的”（n = 30）。
依从患者的体重指数、体重、脂肪百分比、脂肪量、去脂体重和肌肉量随时间没有显著下降，但在不依从患者中，与治疗结束时相比，所有这些指标均较基线显著下降（P < 0.001）。两组在基线时和每组随时间的握力没有显著差异。回顾性评估时，依从患者中重度黏膜炎的发生率低于不依从患者（分别为11.1%和88.9%）（P < 0.009）。
我们得出结论，在放疗期间，被认为依从营养咨询的头颈部癌患者的身体成分参数优于不依从的患者。
