Huong Le Thi, Phuong Duong Thi, Anh Dang Kim, Toi Phung Lam, Anh Nguyen Le Tuan, Huy Trinh Le, Linh Nguyen Thuy
Nutrition and Dietetics Department, Hanoi Medical University Hospital, Hanoi 10000, Vietnam.
Institute of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 10000, Vietnam.
Healthcare (Basel). 2021 Jul 4;9(7):843. doi: 10.3390/healthcare9070843.
Evidence on the effects of nutritional interventions on gastrointestinal cancer patients receiving chemotherapy is not well documented. This study aims to assess the effects of nutritional intervention in patients diagnosed with stomach and colon cancer receiving chemotherapy in Vietnam.
A quasi-experiment with intervention and control groups for pre- and post-intervention was carried out in cancer patients receiving chemotherapy in a university hospital in Vietnam. Patients in the intervention group were provided nutritional counseling, personalized specific dietary advice, and received oral nutrition supplements (ONSs) while patients in the control group only received nutrition counseling.
The weight in the intervention and control group after 2 months increased significantly by 1.4 ± 2.6 kg and 0.4 ± 2.3 kg, respectively. Muscle mass increased by 1.2 ± 4.1 cm in the intervention group, while those in the control group decreased by 0.55 ± 2.77 cm. There was no statistical significance between two groups after intervention in terms of Mid-Upper Arm Circumference (MUAC) and percentage of fat. The percentage of malnutrition based on the Scored Patient-Generated Subjective Global Assessment (PG-SGA) and Body Mass Index (BMI) declined after the intervention in both groups. According to the average treatment effect on the treated (ATT) using the propensity score matching and DiD method, participants receiving the intervention were more likely to have a higher score of weight (Coef = 0.84; 95%CI = 0.47; 2.16) and muscle mass (Coef = 1.08; 95%CI = 0.09; 2.06) between pre- and post-intervention. By contrast, the PG-SGA scores on treated participants were more likely to decrease after the intervention (Coef = -1.28; 95%CI = -4.39; -0.84). After matching, being female, living in rural areas, or having stomach cancer were still positively related to being moderately/severely malnourished by the PG-SGA, and these findings were statistically significant ( < 0.05).
The nutritional interventions had a positive effect on weight gain, muscle mass, and reduced malnutrition. Further studies with a longer follow-up duration are needed to confirm the effects of the intervention.
关于营养干预对接受化疗的胃肠道癌症患者影响的证据尚无充分记录。本研究旨在评估营养干预对越南诊断为胃癌和结肠癌且正在接受化疗患者的影响。
在越南一家大学医院对接受化疗的癌症患者进行了一项有干预组和对照组的准实验，分别在干预前后进行观察。干预组患者接受营养咨询、个性化的特定饮食建议，并接受口服营养补充剂（ONS），而对照组患者仅接受营养咨询。
2个月后，干预组和对照组的体重分别显著增加了1.4±2.6千克和0.4±2.3千克。干预组的肌肉量增加了1.2±4.1厘米，而对照组的肌肉量减少了0.55±2.77厘米。干预后两组之间在上臂中部周长（MUAC）和脂肪百分比方面无统计学意义。基于评分患者主观整体评估（PG-SGA）和体重指数（BMI）的营养不良百分比在两组干预后均有所下降。根据使用倾向得分匹配和双重差分法对处理组的平均处理效应（ATT），接受干预的参与者在干预前后更有可能有更高的体重得分（系数=0.84；95%置信区间=0.47；2.16）和肌肉量得分（系数=1.08；95%置信区间=0.09；2.06）。相比之下，接受干预后处理组参与者的PG-SGA得分更有可能下降（系数=-1.28；95%置信区间=-4.39；-0.84）。匹配后，女性、居住在农村地区或患有胃癌仍与PG-SGA评估的中度/重度营养不良呈正相关，且这些结果具有统计学意义（<0.05）。
营养干预对体重增加、肌肉量增加和减少营养不良有积极作用。需要进一步进行更长随访期的研究来证实该干预措施的效果。
