癌症相关性厌食症：不同食欲评估工具在初诊癌症患者中随时间的有效性和表现。
Cancer-associated anorexia: Validity and performance overtime of different appetite tools among patients at their first cancer diagnosis.
机构信息
Department of Translational and Precision Medicine, Sapienza University of Rome, V.le dell'Università 37, Rome, Italy.
Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Nutrition and Dietetics, VU Amsterdam Main Building De Boelelaan 1105, 1081 HV, Amsterdam, the Netherlands; HAN University of Applied Sciences, School of Allied Health, Department of Nutrition and Dietetics, Nijmegen, the Netherlands.
出版信息
Clin Nutr. 2021 Jun;40(6):4037-4042. doi: 10.1016/j.clnu.2021.02.016. Epub 2021 Feb 23.
BACKGROUND & AIMS: Anorexia is a frequent symptom in cancer and we aimed to assess its prevalence among patients at their first cancer diagnosis by different appetite tools and the relationship between each tool with self-reports of food intake. We also tested whether cancer anorexia influences outcomes independently of reduced food intake or body weight loss (BWL) overtime and whether BWL was associated with complications during anticancer-therapy.
METHODS
Functional Assessment of Anorexia/Cachexia Therapy (FAACT) score, self-assessment of appetite, Anorexia Questionnaire (AQ) and Visual Analog Scale (VAS) were administered. Percent of food intake was used as a criterion measure of anorexia. We registered BWL and anticancer-therapy complications over 3-month-follow-up.
RESULTS
438 cancer patients from 7 cancer-centers worldwide were included. The prevalence of anorexia was 39.9% by FAACT score, 40.2% by VAS, 40.6% by the self-assessment of appetite and 65.4% by AQ. Low food intake (≤50%) was reported in 28% of patients. All appetite tools correlated with food intake percent (P < 0.0001). We documented a correlation between self-assessment of appetite, FAACT score, VAS and BWL overtime (P < 0.04). The self-assessment of appetite (P = 0.0152) and the FAACT score (P = 0.043) were associated with BWL independently of anticancer therapies. Among patients with BWL, the risk to develop complications was greater with respect to those who maintained a stable or gained body weight (P = 0.03).
CONCLUSIONS
In our sample of cancer patients, FAACT score and self-assessment of appetite performed well when low food intake was used as a criterion measure, and revealed an association of anorexia with BWL, which was, in turn, related to the development of anticancer-therapy complications.
背景与目的
厌食是癌症患者常见的症状，我们旨在通过不同的食欲评估工具评估癌症初诊患者中厌食的发生率，并评估每个工具与患者自我报告的食物摄入量之间的关系。我们还测试了癌症相关性厌食是否会独立于食物摄入减少或体重减轻（body weight loss，BWL）随时间变化而影响结局，以及 BWL 是否与抗癌治疗期间的并发症有关。
方法
使用功能性评估厌食/恶病质治疗量表（functional assessment of anorexia/cachexia therapy，FAACT）评分、自我评估食欲、厌食问卷（anorexia questionnaire，AQ）和视觉模拟量表（visual analog scale，VAS）进行评估。食物摄入量的百分比作为厌食的标准测量值。我们在 3 个月的随访期间记录 BWL 和抗癌治疗的并发症。
结果
来自全球 7 家癌症中心的 438 例癌症患者被纳入研究。FAACT 评分、VAS、自我评估食欲和 AQ 评估的厌食发生率分别为 39.9%、40.2%、40.6%和 65.4%。有 28%的患者报告食物摄入量低（≤50%）。所有的食欲评估工具与食物摄入量百分比均呈正相关（P<0.0001）。我们记录到自我评估食欲、FAACT 评分、VAS 和 BWL 随时间的相关性（P<0.04）。自我评估食欲（P=0.0152）和 FAACT 评分（P=0.043）与 BWL 独立相关，与抗癌治疗无关。在发生 BWL 的患者中，与体重稳定或增加的患者相比，发生并发症的风险更高（P=0.03）。
结论
在我们的癌症患者样本中，当使用低食物摄入量作为标准测量值时，FAACT 评分和自我评估食欲表现良好，且发现厌食与 BWL 相关，而 BWL 又与抗癌治疗相关的并发症有关。
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