MoH Okmeydani Training and Research Hospital Oncology Clinic, Istanbul, Turkey.
Istanbul University Florence Nightingale Faculty of Nursing, Istanbul, Turkey.
Support Care Cancer. 2019 Jan;27(1):239-247. doi: 10.1007/s00520-018-4319-6. Epub 2018 Jun 24.
Patients with head and neck cancers are susceptible to malnutrition during radiotherapy. This study aimed to determine the changes in the nutritional status and its determinants in patients with head and neck cancer during radiotherapy.
This prospective observational study was performed in an outpatient Radiation Oncology clinic with a sample of 54 patients. An interview form (including anthropometric and laboratory parameters), the Patient-Generated Subjective Global Assessment to assess nutritional status, quality of life scales, and toxicity criteria were used for data collection at the baseline, the end of radiotherapy and 1 and 3 months after radiotherapy.
While the majority of the patients (90%) were well nourished at baseline, most of the patients (74%) were malnourished at the end of radiotherapy (p < 0.001). During radiotherapy, patients developed malnutrition, reflected in a decrease in food intake, approximately 5% loss of body weight, a reduction in mid-arm upper circumference and mid-arm muscle mass, and reduced serum protein and albumin levels. The nutritional status was worse in oropharyngeal cancers (p = 0.021), advanced stage (p = 0.004), use of concomitant chemotherapy (p = 0.041), and worse toxicity (p < 0.001). Furthermore, the nutritional status was strongly associated with the quality of life.
This study demonstrated negative impact of radiotherapy on the nutritional status of patients with head and neck cancer. The study also showed the association of the nutritional status and the quality of life. The nutritional status should be assessed during different periods in the trajectory of treatment due to its significant contribution to the quality of life.
头颈部癌症患者在放疗期间易发生营养不良。本研究旨在确定放疗期间头颈部癌症患者营养状况的变化及其决定因素。
本前瞻性观察研究在门诊放疗科进行，样本量为 54 例患者。采用访谈表（包括人体测量和实验室参数）、患者生成的主观整体评估来评估营养状况、生活质量量表和毒性标准，在基线、放疗结束时以及放疗后 1 个月和 3 个月收集数据。
虽然大多数患者（90%）在基线时营养良好，但大多数患者（74%）在放疗结束时存在营养不良（p<0.001）。在放疗过程中，患者出现营养不良，表现为食物摄入量减少、体重减轻约 5%、上臂中部周长和上臂中部肌肉量减少以及血清蛋白和白蛋白水平降低。口咽癌（p=0.021）、晚期（p=0.004）、同时进行化疗（p=0.041）和毒性更严重的患者（p<0.001）的营养状况更差。此外，营养状况与生活质量密切相关。
本研究表明放疗对头颈部癌症患者营养状况有负面影响。研究还表明营养状况与生活质量相关。由于营养状况对生活质量有重要影响，因此应在治疗过程的不同阶段评估营养状况。
