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接受化疗的肿瘤患者中,胃肠道症状并存与味觉改变相关。

Co-occurring Gastrointestinal Symptoms Are Associated With Taste Changes in Oncology Patients Receiving Chemotherapy.

机构信息

Food Science Department, College of Natural Sciences, University of Massachusetts, Amherst, Massachusetts, USA.

Sensory Science & Metabolism Unit, Biobehavioral Branch, Division of Intramural Research, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA.

出版信息

J Pain Symptom Manage. 2019 Nov;58(5):756-765. doi: 10.1016/j.jpainsymman.2019.07.016. Epub 2019 Jul 23.

Abstract

CONTEXT

Over 80% of patients with cancer report taste changes. Despite the high prevalence of this symptom and its negative effects on health, few studies have assessed its association with other gastrointestinal (GI) symptoms.

OBJECTIVES

Determine the occurrence, frequency, severity, and distress of patient-reported "change in the way food tastes" (CFT) and identify phenotypic and GI symptoms characteristics associated with its occurrence.

METHODS

Patients receiving chemotherapy for breast, GI, gynecological, or lung cancer completed demographic and symptom questionnaires prior to their second or third cycle of chemotherapy. CFT was assessed using the Memorial Symptom Assessment Scale. Differences in demographic, clinical, and GI symptom characteristics were evaluated using parametric and nonparametric tests.

RESULTS

Of the 1329 patients, 49.4% reported experiencing CFT in the week prior to their second or third cycle of chemotherapy. In the univariate analysis, patients who reported CFT had fewer years of education; were more likely to be black or Hispanic, mixed race, or other; and had a lower annual household income. A higher percentage of patients with CFT reported the occurrence of 13 GI symptoms (e.g., constipation, diarrhea, abdominal cramps, feeling bloated). In a multivariable logistic regression analysis, compared with patients with breast cancer, patients with lung cancer (odds ratio = 0.55; P = 0.004) had a decrease in the odds of being in the CFT group. Patients who received a neurokinin-1 receptor antagonist and two other antiemetics were at an increased odds of being in the CFT group (odds ratio = 2.51; P = 0.001). Eight of the 13 GI symptoms evaluated were associated with an increased odds of being in the CFT group.

CONCLUSIONS

This study provides new evidence on the frequency, severity, and distress of CFT in oncology patients undergoing chemotherapy. These findings suggest that CFT is an important problem that warrants ongoing assessments and nutritional interventions.

摘要

背景

超过 80%的癌症患者报告味觉改变。尽管这种症状很常见,且对健康有负面影响,但很少有研究评估其与其他胃肠道(GI)症状的关系。

目的

确定患者报告的“食物味道变化”(CFT)的发生、频率、严重程度和困扰程度,并确定与其发生相关的表型和 GI 症状特征。

方法

接受乳腺癌、胃肠道、妇科或肺癌化疗的患者在接受第二或第三周期化疗前完成人口统计学和症状问卷。使用 Memorial 症状评估量表评估 CFT。使用参数和非参数检验评估人口统计学、临床和 GI 症状特征的差异。

结果

在 1329 名患者中,49.4%在接受第二或第三周期化疗前一周报告经历了 CFT。在单因素分析中,报告 CFT 的患者受教育年限较少;更有可能是黑种人或西班牙裔、混血或其他种族;家庭年收入较低。更多报告 CFT 的患者出现 13 种胃肠道症状(如便秘、腹泻、腹部痉挛、腹胀)。在多变量逻辑回归分析中,与乳腺癌患者相比,肺癌患者(比值比=0.55;P=0.004)CFT 组的发生几率降低。接受神经激肽-1 受体拮抗剂和另外两种止吐药的患者 CFT 组的发生几率增加(比值比=2.51;P=0.001)。评估的 13 种胃肠道症状中有 8 种与 CFT 组发生几率增加相关。

结论

本研究提供了化疗肿瘤患者 CFT 频率、严重程度和困扰的新证据。这些发现表明 CFT 是一个重要问题,需要进行持续评估和营养干预。

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