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接受化疗/放化疗的癌症患者的口服营养补充:一项多中心、随机的 II 期研究。

Oral Nutritional Supplementation in Cancer Patients Who Were Receiving Chemo/Chemoradiation Therapy: A Multicenter, Randomized Phase II Study.

机构信息

Department of Oncology, IRPCC - Instituto Ribeiraopretano de Combate ao Cancer, Ribeirao Preto, Brazil.

Department of Nutrition, IRPCC - Instituto Ribeiraopretano de Combate ao Cancer, Ribeirao Preto, Brazil.

出版信息

Nutr Cancer. 2021;73(3):442-449. doi: 10.1080/01635581.2020.1758170. Epub 2020 May 2.

Abstract

Oral nutritional supplementation (ONS) in cancer patients is justified by the low food intake caused by several factors. However, ONS can be affected by adverse events (AEs) correlated to treatment. This study aimed to compare the safety and efficacy of ONS (whey protein isolated, leucin, zinc-IMMAX®) during oncologic treatment. Patients in chemo/chemoradiotherapy were randomly assigned to receive IMMAX®+nutritional counseling (NC) according to daily requirements (S arm) or NC alone (C arm) for 4 weeks. Body weight (BW), %fat-free mass (%FFM) and nutrition intake were assessed before and after. In S arm, calories from IMMAX met the energy requirements. AEs were classified according to CTC-AE-NCI. Eighty-five patients were included (51 females). After 4 weeks, the median of caloric intake, BW and %FFM were not statistically different in C arm. In S arm, median ONS intake was 81 g/332 kcal/day, protein intake was higher (pre: 66.75 ± 31.57 g; post: 88.57 ± 35.11 g;  < 0.01) and calories as well (pre: 1,549 ± 596 kcal; post: 1,756 ± 614 kcal;  = 0.02). The most common treatment related AEs were anemia, nausea/vomiting, not different between the arms. AEs supplement related were constipation and diarrhea (2 patients/4.6% each). IMMAX was safe, well tolerated, it did not interfere with oncologic treatment and provided significant amount of protein intake in this patient population, with few related AEs.

摘要

口服营养补充(ONS)在癌症患者中是合理的,因为多种因素导致食物摄入不足。然而,ONS 可能会受到与治疗相关的不良事件(AEs)的影响。本研究旨在比较ONS(乳清蛋白分离物、亮氨酸、锌-IMMAX®)在肿瘤治疗期间的安全性和疗效。接受化疗/放化疗的患者被随机分为接受根据日常需求给予 IMMAX®+营养咨询(NC)的 S 组(S 臂)或单独给予 NC 的 C 组(C 臂),共 4 周。在治疗前后评估体重(BW)、去脂体重百分比(%FFM)和营养摄入。在 S 臂中,来自 IMMAX 的热量满足能量需求。根据 CTC-AE-NCI 对 AEs 进行分类。共纳入 85 例患者(51 例女性)。4 周后,C 臂中热量摄入、BW 和 %FFM 的中位数无统计学差异。在 S 臂中,ONS 中位摄入量为 81g/332kcal/天,蛋白质摄入量更高(治疗前:66.75±31.57g;治疗后:88.57±35.11g; <0.01),热量也更高(治疗前:1549±596kcal;治疗后:1756±614kcal; =0.02)。最常见的与治疗相关的 AEs 是贫血、恶心/呕吐,两组之间无差异。与补充剂相关的 AEs 是便秘和腹泻(各 2 例/4.6%)。IMMAX 是安全的,耐受性良好,它不会干扰肿瘤治疗,并为该患者人群提供了大量的蛋白质摄入,相关 AEs 很少。

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