Nutrition Services Department, St Vincent's Hospital, Sydney, Australia.
Faculty of Health Sciences, The University of Sydney, 75 East Street, Lidcombe, Sydney, NSW, 2141, Australia.
Support Care Cancer. 2020 Jan;28(1):341-349. doi: 10.1007/s00520-019-04826-w. Epub 2019 May 2.
This study analysed nutritional parameters (baseline body mass index (BMI), weight changes and enteral nutrition (EN) use, and their association with hospital admissions during radiotherapy in patients with head and neck cancer (HNC)).
A retrospective review of patients diagnosed with HNC and treated with radiotherapy between October 2012 and April 2014 was conducted. Data on each subject's diagnosis, age, sex, chemotherapy, previous surgery, EN use, weight changes, and BMI were examined for their association with hospital admissions during treatment.
Eighty-three patients were included, mean age (±standard deviation) = 61 (± 11 years). Thirty-four percent had self-reported weight loss at diagnosis, and mean BMI was 26.2 ± 5.3 kg/m. Mean weight change during treatment was - 5.1 ± 6.2%. Ten patients used EN, with mean weight stabilisation during EN use (0.3 ± 5.1%). Higher presenting BMI, younger age, and definitive radiotherapy ± chemotherapy predicted greater weight loss (p < 0.05). Critical weight loss ≥ 5% was associated with a higher number of hospital admissions for nutrition reasons (n = 10) (p = 0.011) compared with those without critical weight loss (n = 2). EN use was associated with a higher number of nutrition-related admissions; however, it did not predict length of stay among those admitted.
Critical weight loss during radiotherapy was associated with unplanned nutrition-related hospital admissions. Higher BMI was associated with greater weight loss during radiotherapy, whilst EN use assisted in weight preservation. Further research around patient selection for nutritional interventions aimed at preventing critical weight loss and unplanned hospital admissions is needed.
本研究分析了营养参数（基线体重指数（BMI）、体重变化和肠内营养（EN）的使用及其与头颈部癌症（HNC）患者放疗期间住院的关系）。
回顾性分析了 2012 年 10 月至 2014 年 4 月期间诊断为 HNC 并接受放疗的患者。检查每位患者的诊断、年龄、性别、化疗、既往手术、EN 使用、体重变化和 BMI 与治疗期间住院的关系。
共纳入 83 例患者，平均年龄（±标准差）=61（±11 岁）。34%的患者在诊断时自述体重减轻，平均 BMI 为 26.2±5.3kg/m。治疗期间平均体重减轻 5.1±6.2%。10 例患者使用 EN，EN 使用期间平均体重稳定（0.3±5.1%）。较高的初始 BMI、较年轻的年龄和确定性放疗±化疗预测体重减轻更大（p<0.05）。与未发生临界体重减轻的患者（n=2）相比，临界体重减轻≥5%与因营养原因而需要更多住院治疗（n=10）（p=0.011）相关。EN 使用与更多与营养相关的住院有关；然而，它并不能预测住院患者的住院时间。
放疗期间的临界体重减轻与计划外的营养相关住院有关。较高的 BMI 与放疗期间更大的体重减轻相关，而 EN 使用有助于保持体重。需要进一步研究针对营养干预措施的患者选择，以预防临界体重减轻和计划外住院。
