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化疗对老年胃肠道系统癌症患者营养状况和虚弱的影响。

The effect of chemotherapy on nutritional status and weakness in geriatric gastrointestinal system cancer patients.

机构信息

Ege University School of Medicine, Department of Medical Oncology, Bornova, Izmir, Turkey.

Ege University School of Medicine, Department of Medical Oncology, Bornova, Izmir, Turkey.

出版信息

Nutrition. 2018 Mar;47:39-42. doi: 10.1016/j.nut.2017.09.013. Epub 2017 Oct 12.

Abstract

OBJECTIVES

Malnutrition is common in patients with geriatric gastrointestinal system (GIS) cancer. This study aimed to evaluate patients with geriatric GIS cancer in terms of nutritional status and weakness and determine the changes caused by chemotherapy (CT).

METHODS

Patients with geriatric GIS cancer who received CT were included in the study. Their nutritional status was assessed with the Mini Nutritional Assessment, and weakness was assessed with the handgrip strength/body mass index ratio. After CT (minimum 4 wk and maximum 6 wk later), patients were assessed for the same parameters.

RESULTS

A total of 153 patients aged ≥65 y (mean age, 70.5 ± 5.6 y; 44 female and 109 male) were evaluated. The population consisted of patients who were diagnosed with colorectal (51.6%), gastric (26.8%), pancreatic (11.8%), hepatic (7.2%), biliary tract (2%), and esophageal (0.7%) cancer. Of these patients, 37.9% were malnourished, 34.6% were at risk of malnutrition, and 27.5% were well nourished. After one course of CT, the frequency of malnutrition increased to 46.4% (P = 0.001). The patient groups with the highest rates of weakness were those who were diagnosed with biliary tract, hepatic, and colorectal cancer (33.3%, 27.3%, and 20%, respectively). Weakness was significantly increased after one course of CT in patients who received CT before (P = 0.039).

CONCLUSIONS

Malnutrition and weakness were common in patients with geriatric GIS cancer, and even one course of CT worsened the nutritional status of the patients. Patients who have received CT previously should be carefully monitored for weakness.

摘要

目的

老年胃肠道系统(GIS)癌症患者普遍存在营养不良的情况。本研究旨在评估老年 GIS 癌症患者的营养状况和虚弱程度,并确定化疗(CT)引起的变化。

方法

纳入接受 CT 的老年 GIS 癌症患者。使用微型营养评估评估他们的营养状况,使用握力/体重指数比评估虚弱程度。在 CT 后(最少 4 周,最多 6 周后),对患者进行相同参数的评估。

结果

共评估了 153 名年龄≥65 岁的患者(平均年龄 70.5±5.6 岁;44 名女性和 109 名男性)。该人群包括被诊断为结直肠癌(51.6%)、胃癌(26.8%)、胰腺癌(11.8%)、肝癌(7.2%)、胆道癌(2%)和食管癌(0.7%)的患者。其中,37.9%的患者存在营养不良,34.6%存在营养不良风险,27.5%营养良好。在一个疗程的 CT 后,营养不良的发生率增加到 46.4%(P=0.001)。在被诊断患有胆道癌、肝癌和结直肠癌的患者中,虚弱的发生率最高(分别为 33.3%、27.3%和 20%)。在接受过 CT 的患者中,在接受一个疗程的 CT 后,虚弱明显增加(P=0.039)。

结论

老年 GIS 癌症患者普遍存在营养不良和虚弱,甚至一个疗程的 CT 也会使患者的营养状况恶化。先前接受过 CT 的患者应密切监测虚弱情况。

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