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头颈部癌患者放疗期间及放疗后体重减轻的预测因素:一项纵向研究。

Predictors of weight loss during and after radiotherapy in patients with head and neck cancer: A longitudinal study.

作者信息

Lee Shu-Chiung, Wang Tsae-Jyy, Chu Pen-Yuan

机构信息

MSN RN, Nurse Supervisor, Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.

School of Nursing, National Taipei University of Nursing and Health Science, Taipei, Taiwan, ROC.

出版信息

Eur J Oncol Nurs. 2019 Apr;39:98-104. doi: 10.1016/j.ejon.2019.02.004. Epub 2019 Feb 20.

DOI:10.1016/j.ejon.2019.02.004
PMID:30850144
Abstract

PURPOSE

Weight loss is a multifactorial condition that commonly affects patients receiving radiotherapy for head and neck cancers. The aims of this study were to 1) describe body weight changes over time in patients receiving radiotherapy for head and neck cancers and 2) explore the influence of pretreatment weight loss, body mass index (BMI) category, symptom burden, mucositis, and nutritional support on body weight changes over time.

METHODS

Using a longitudinal design, this study investigated a consecutive cohort of head and neck cancer patients who were treated with radiotherapy between January 2015 to January 2016 in a Taiwan medical center (n = 128). Data regarding symptom burden, mucositis severity, and body weight were collected before radiotherapy (T1), one month after the initial radiotherapy (T2), at the completion of radiotherapy (T3), and one month after the completion of radiotherapy (T4).

RESULTS

On average, the participants' body weight decreased by 3.09 kg (SD = 2.79) from T1 to T2, 1.72 kg (SD = 2.06) from T2 to T3, and continued to decrease by 1.04 kg (SD = 2.87) from T3 to T4. The results of a generalized estimating equation showed that BMI category, symptom burden, mucositis, and nutritional support were directly and independently related to body weight changes over time in patients with head and neck cancers.

CONCLUSIONS

Head and neck cancer patients experience significant weight loss during and after radiotherapy. The study findings are relevant for assessing nutritional status and providing necessary support measures at critical moments for patients treated with radiotherapy.

摘要

目的

体重减轻是一种多因素状况,常见于接受头颈癌放疗的患者。本研究的目的是:1)描述接受头颈癌放疗患者的体重随时间的变化;2)探讨放疗前体重减轻、体重指数(BMI)类别、症状负担、黏膜炎和营养支持对体重随时间变化的影响。

方法

采用纵向设计,本研究调查了2015年1月至2016年1月在台湾一家医疗中心接受放疗的连续队列头颈癌患者(n = 128)。在放疗前(T1)、首次放疗后1个月(T2)、放疗结束时(T3)以及放疗结束后1个月(T4)收集有关症状负担、黏膜炎严重程度和体重的数据。

结果

平均而言,参与者的体重从T1到T2下降了3.09千克(标准差 = 2.79),从T2到T3下降了1.72千克(标准差 = 2.06),并且从T3到T4继续下降了1.04千克(标准差 = 2.87)。广义估计方程的结果表明,BMI类别、症状负担、黏膜炎和营养支持与头颈癌患者体重随时间的变化直接且独立相关。

结论

头颈癌患者在放疗期间和放疗后体重显著减轻。研究结果对于评估营养状况以及在放疗患者的关键时期提供必要的支持措施具有重要意义。

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