Sukaraphat Napawan, Chewaskulyong Busyamas, Buranapin Supawan
J Med Assoc Thai. 2016 Dec;99(12):1283-90.
Cancer-related malnutrition led to poor outcomes of treatment, decreased functional status, decreased quality of life, and delay treatment.
To examine the effects of dietary counseling for regular foods consumption on nutritional outcomes in patients with cancer undergoing chemotherapy.
A prospective randomized study was performed on locally advanced unresectable or metastatic cancer patients undergoing chemotherapy at Department of Medicine, Chiang Mai University, between December 2013 and July 2014. Fifty patients were randomly assigned to dietary counseling group and routine care group. The dietary counseling was performed by a dietitian before starting chemotherapy. Outcomes were evaluated at the end of three to four cycles and six to eight cycles of chemotherapy or after two months if the chemotherapy was stopped earlier.
The dietary counseling group significantly increased percent change of body weight 2.29 (±6.20) vs. -1.70 (±6.23) percent in the routine care group, p = 0.03 and increased BMI 2.27 (±6.09) vs. -1.53 (±5.92) percent, p = 0.03 at the end of three to four cycles of chemotherapy, but there was no significant change at the next two months. Furthermore, PG-SGA score was lower in the dietary counseling group (6.67 (±1.99) vs. 10.04 (±3.73), p<0.001, and quality of life was significant increased in dietary counseling group at the end of three to four cycles of chemotherapy and at the next two months (score 39.40 (±10.61) vs 46.16 (±7.55), p = 0.01). Absolute lymphocyte count, serum albumin, energy intake, number of patients who delayed chemotherapy, cause of delay chemotherapy, and number of total cycles did not differ between the groups.
Dietary counseling have significantly improved body weight, BMI, PG-SGA scores, and quality of life scores in patients with locally advanced unresectable or metastatic cancer undergoing chemotherapy compared with routine care. We should be concerned about screening for malnutrition in all cancer patients and we should provide nutritional counseling.
癌症相关营养不良导致治疗效果不佳、功能状态下降、生活质量降低及治疗延迟。
探讨针对常规食物摄入的饮食咨询对接受化疗的癌症患者营养结局的影响。
2013年12月至2014年7月，在清迈大学医学部对接受化疗的局部晚期不可切除或转移性癌症患者进行了一项前瞻性随机研究。50例患者被随机分为饮食咨询组和常规护理组。饮食咨询由一名营养师在化疗开始前进行。在化疗三到四个周期和六到八个周期结束时或如果化疗提前停止则在两个月后评估结局。
在化疗三到四个周期结束时，饮食咨询组体重变化百分比显著增加，为2.29（±6.20）%，而常规护理组为-1.70（±6.23）%，p = 0.03；体重指数增加，分别为2.27（±6.09）%和-1.53（±5.92）%，p = 0.03，但在接下来的两个月没有显著变化。此外，饮食咨询组的患者主观全面评定（PG-SGA）评分较低（6.67（±1.99）对10.04（±3.73），p<0.001），并且在化疗三到四个周期结束时及接下来的两个月，饮食咨询组的生活质量显著提高（评分39.40（±10.61）对46.16（±7.55），p = 0.01）。两组之间的绝对淋巴细胞计数、血清白蛋白、能量摄入、延迟化疗的患者数量、延迟化疗的原因及总周期数没有差异。
与常规护理相比，饮食咨询显著改善了接受化疗的局部晚期不可切除或转移性癌症患者的体重、体重指数、PG-SGA评分及生活质量评分。我们应该关注对所有癌症患者的营养不良筛查，并应提供营养咨询。
