Neoh May Kay, Abu Zaid Zalina, Mat Daud Zulfitri Azuan, Md Yusop Nor Baizura, Ibrahim Zuriati, Abdul Rahman Zuwariah, Jamhuri Norshariza
Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Seri Kembangan 43400, Selangor, Malaysia.
Department of Dietetic and Food Service, National Cancer Institute, Ministry of Health, 4, Jalan P7, Presint 7, Putrajaya 62250, Malaysia.
Nutrients. 2020 Apr 26;12(5):1225. doi: 10.3390/nu12051225.
The purpose of this study is to evaluate changes in nutrition impact symptoms (NIS) and nutritional and functional status that occur throughout radiotherapy in head and neck cancer (HNC) patients.
A prospective observational study of HNC inpatients who underwent radiotherapy with or without chemotherapy were recruited to participate. Fifty patients were followed for the periods before, in the middle and at the end of radiotherapy. Nutritional parameters were collected throughout radiotherapy.
According to Patient-Generated Subjective Global Assessment (PG-SGA), there was an increase from a baseline of 56% malnourished HNC patients to 100% malnourished with mean weight loss of 4.53 ± 0.41kg (7.39%) at the end of radiotherapy. Nutritional parameters such as muscle mass, fat mass, body mass index, dietary energy and protein intake decrease significantly ( < 0.0001) while NIS score, energy and protein intake from oral nutritional supplements (ONS) increased significantly ( < 0.0001). Hand grip strength did not differ significantly. All HNC patients experienced taste changes and dry mouth that required ONS at the end of treatment. ONS compliance affected the percentage of weight loss ( = 0.013).
The intensive nutritional care time point was the middle of RT. The PG-SGA and NIS checklist are useful for monitoring nutrition for HNC patients.
本研究旨在评估头颈部癌（HNC）患者在整个放疗过程中营养影响症状（NIS）以及营养和功能状态的变化。
招募接受放疗（有或无化疗）的HNC住院患者进行一项前瞻性观察研究。50例患者在放疗前、放疗中期和放疗结束时接受随访。在整个放疗过程中收集营养参数。
根据患者主观全面评定法（PG-SGA），放疗结束时，营养不良的HNC患者从基线时的56%增至100%，平均体重减轻4.53±0.41kg（7.39%）。肌肉量、脂肪量、体重指数、膳食能量和蛋白质摄入量等营养参数显著下降（<0.0001），而NIS评分、口服营养补充剂（ONS）的能量和蛋白质摄入量显著增加（<0.0001）。握力无显著差异。所有HNC患者在治疗结束时均出现味觉改变和口干，需要ONS。ONS依从性影响体重减轻百分比（=0.013）。
强化营养护理的时间点为放疗中期。PG-SGA和NIS清单有助于监测HNC患者的营养状况。
