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营养不良与非小细胞肺癌患者的生活质量。

Malnutrition and Quality of Life in Patients with Non-Small-Cell Lung Cancer.

机构信息

Lower Silesian Oncology Center, Home Hospice, 12 Hirszfeld Square, Wroclaw, 53-413, Poland.

Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, 5 Bartla Streetd, Wroclaw, 51-618, Poland.

出版信息

Adv Exp Med Biol. 2017;1021:15-26. doi: 10.1007/5584_2017_23.

Abstract

Progressive weight loss, common reduces performance and quality of life in patients with advanced lung cancer. However, there is a paucity of studies that focus on nutritional status and quality of life of non-small cell lung cancer (NSCLC) patients. The present study seeks to determine the nutritional status, and its relation to quality of life, of NSCLC patients. One hundred and eighty NSCLC patients (mean age 62.8 ± 9.6 years) were evaluated during therapy at the Lower Silesian Center of Lung Diseases in Wroclaw, Poland. Nutritional status was evaluated by means of the Mini-Nutritional Assessment (MNA) and quality of life by means of two instruments developed by the European Organization for the Research and Treatment of Cancer (EORTC): QLQ-C30 and QLQ-LC13 questionnaires. The MNA revealed that up to 51.1% of patients were undernourished, 23.9% were at risk of malnutrition, and only 25.0% showed a normal nutrition. The well-nourished respondents evaluated their quality of life better in all functional scales (33.3 vs. 41.7 vs. 66.7, respectively) and presented less intensive symptoms in general QLQ-C30 and specific LC13 questionnaires. In univariate analysis, malnutrition significantly correlated with decreased quality of life and the intensity of symptoms in both questionnaires. In multivariate analysis, malnutrition was an independent determinant of decreased quality of life in physical functioning domain (β = -0.015; p < 0.001). We conclude that malnutrition has an impact on quality of life and on the presentation of symptoms in NSCLC patients. Therefore, nutritional care should be integrated into the global oncology as an adjunct to symptomatic treatment.

摘要

体重逐渐减轻会降低晚期肺癌患者的身体机能和生活质量。然而,目前针对非小细胞肺癌(NSCLC)患者营养状况与生活质量的研究较少。本研究旨在确定 NSCLC 患者的营养状况及其与生活质量的关系。研究共纳入了 180 名 NSCLC 患者(平均年龄 62.8±9.6 岁),这些患者在波兰弗罗茨瓦夫下西里西亚肺病中心接受治疗。营养状况通过 Mini-Nutritional Assessment(MNA)进行评估,生活质量通过欧洲癌症研究与治疗组织(EORTC)开发的两个工具进行评估:QLQ-C30 和 QLQ-LC13 问卷。MNA 显示,多达 51.1%的患者存在营养不良,23.9%的患者有发生营养不良的风险,仅有 25.0%的患者营养状况正常。营养状况良好的受访者在所有功能量表中(分别为 33.3、41.7 和 66.7)自评生活质量更好,在一般 QLQ-C30 和特定 LC13 问卷中报告的症状强度也更低。单因素分析表明,营养不良与生活质量下降和两个问卷中症状强度增加显著相关。多因素分析表明,营养不良是影响 NSCLC 患者生理功能领域生活质量下降的独立因素(β=-0.015;p<0.001)。综上,我们得出结论,营养不良会对 NSCLC 患者的生活质量和症状表现产生影响。因此,营养护理应作为辅助治疗,纳入到整体肿瘤治疗中。

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