Nutritionist, Palliative Care Unit, José Alencar Gomes da Silva National Cancer Institute, Rua Visconde de Santa Isabel, 274, Vila Isabel, Rio de Janeiro, RJ, Brazil.
Institutional Development Grant, José Alencar Gomes da Silva National Cancer Institute, Rio de Janeiro, RJ, Brazil.
Support Care Cancer. 2020 Oct;28(10):4971-4978. doi: 10.1007/s00520-020-05339-7. Epub 2020 Feb 7.
Nutritional impairment is common in cancer patients and adversely affects quality of life (QoL). The aim of this study was to investigate the association between nutritional status and QoL in incurable cancer patients in palliative care.
A prospective cohort with incurable cancer patients referred to the specialized Palliative Care Unit of the National Cancer Institute in Brazil was conducted. The nutritional risk (NR) was assessed using the Patient-Generated Subjective Global Assessment short form (PG-SGA SF), and cancer cachexia (CC) was defined according to the international consensus. QoL was evaluated using the Quality of Life Questionnaire Core 15 Palliative (QLQ-C15-PAL). Multivariate linear regressions analyses were performed to assess the relationship between the nutritional status and QoL scores.
A total of 1039 consecutive patients were included. A high prevalence of NR (85.4%) and CC (78.7%) were observed. The patients with worse nutritional status presented significantly poorer physical, emotional, symptoms domains scales, and overall QoL. CC were significantly associated with QoL scores for dyspnea (p = 0.013), insomnia (p = 0.046), and appetite loss (p = 0.015), while NR were associated with all the QoL domains scales covered in QLQ-C15-PAL.
Our findings support that impaired nutritional status was associated with poor QoL in incurable cancer patients. NR assessed by PG-SGA SF better reflects physical, emotional, symptom burden, and overall QoL scores. Thus, this tool may contribute in identifying patients at risk of deterioration QoL.
营养损害在癌症患者中很常见，并且会对生活质量（QoL）产生不利影响。本研究的目的是调查姑息治疗中不可治愈的癌症患者的营养状况与生活质量之间的关系。
对巴西国家癌症研究所专门的姑息治疗病房的不可治愈的癌症患者进行了前瞻性队列研究。使用患者主观整体评估简短形式（PG-SGA SF）评估营养风险（NR），并根据国际共识定义癌症恶病质（CC）。使用生活质量问卷核心 15 个姑息治疗（QLQ-C15-PAL）评估生活质量。进行多元线性回归分析以评估营养状况与生活质量评分之间的关系。
共纳入了 1039 例连续患者。观察到高比例的 NR（85.4%）和 CC（78.7%）。营养状况较差的患者在身体、情感、症状领域评分以及总体生活质量方面明显较差。CC 与呼吸困难（p=0.013）、失眠（p=0.046）和食欲下降（p=0.015）的生活质量评分显著相关，而 NR 与 QLQ-C15-PAL 涵盖的所有生活质量领域评分相关。
我们的研究结果表明，营养状况受损与不可治愈的癌症患者生活质量差有关。PG-SGA SF 评估的 NR 更好地反映了身体、情感、症状负担和总体生活质量评分。因此，该工具可能有助于识别生活质量恶化风险的患者。
