Lehner Uta, Zaretsky Eugen, Goeze Almut, Wermter Laura, Birk Richard, Neff Andreas, Fisher Ingo, Ghanaati Shahram, Daffner Anna, Sader Robert, Hey Christiane
Abt. für Phoniatrie und Pädaudiologie, KHNO, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Philipps-Universität Marburg, Marburg, Germany.
Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Philipps-Universität Marburg, Marburg, Germany.
Laryngorhinootologie. 2022 Aug;101(8):652-659. doi: 10.1055/a-1823-1143. Epub 2022 May 2.
Head-and-neck cancer patients run a high risk of peri- or post-treatment malnutrition that can severely affect the therapy outcome. However, little is known about malnutrition under the pre-treatment condition. Therefore, this study aimed to provide a systematic description of the pre-treatment nutritional status and risk of malnutrition in this population.
Before the onset of the oncological therapy, nutritional status of 102 head-and-neck cancer patients was assessed by body mass index (BMI), their risk of malnutrition by "Nutritional Risk Screening" (NRS). Tumour stage and site, patients' age and sex as well as oropharyngeal dysphagia were analysed as possible influence factors. The latter was quantified by the Flexible Endoscopic Evaluation of Swallowing (FEES).
According to BMI, malnutrition (undernutrition) was found in 6% of patients, a risk of malnutrition (NRS) in 27% of patients, and oropharyngeal dysphagia in 15%. In a linear regression, only oropharyngeal dysphagia was identified as a significant influence factor for the risk of malnutrition ( = 0.380/3.776; < .001).
Pre-treatment risk of malnutrition was found in a quarter of head-and-neck cancer patients. For the early identification of this risk and for the introduction of measures that would help to avoid it, a pre-treatment examination of swallowing functions and a systematic malnutrition screening by means of NRS are recommended.
头颈癌患者在治疗期间或治疗后极易出现营养不良，这会严重影响治疗效果。然而，对于治疗前的营养不良情况却知之甚少。因此，本研究旨在系统描述该人群治疗前的营养状况及营养不良风险。
在肿瘤治疗开始前，通过体重指数（BMI）评估102名头颈癌患者的营养状况，采用“营养风险筛查”（NRS）评估其营养不良风险。分析肿瘤分期和部位、患者年龄和性别以及口咽吞咽困难等可能的影响因素。后者通过吞咽功能的软性内镜评估（FEES）进行量化。
根据BMI，6%的患者存在营养不良（营养不足），27%的患者有营养不良风险（NRS），15%的患者存在口咽吞咽困难。在线性回归分析中，仅口咽吞咽困难被确定为营养不良风险的显著影响因素（=0.380/3.776；<.001）。
四分之一的头颈癌患者存在治疗前营养不良风险。为早期识别该风险并采取有助于避免该风险的措施，建议进行治疗前吞咽功能检查及通过NRS进行系统的营养不良筛查。
