Chitwood Holly, Hampton Debra, Patel Reema
University of Kentucky, College of Nursing, College of Nursing Building, 751 Rose Street, Lexington, KY, 40536, USA; University of Kentucky, College of Medicine, Department of Internal Medicine, Medical Oncology, Markey Cancer Center, 800 Rose Street, Lexington, KY, 40536, USA.
University of Kentucky, College of Nursing, College of Nursing Building, 751 Rose Street, Lexington, KY, 40536, USA.
Eur J Oncol Nurs. 2022 Oct;60:102186. doi: 10.1016/j.ejon.2022.102186. Epub 2022 Aug 2.
The purpose of this study was to evaluate use of a proprietary amino acid-oral rehydration solution (AA-ORS) known as Enterade® to reduce the severity of chemotherapy related diarrhea (CRD), to improve patient reported Quality of Life (QOL), and to reduce treatment holds, delays, dose modifications, prevention of weight loss, and subjective improvement of associated gastrointestinal mucositis physical symptoms.
An experimental pilot study without randomization in a single population with two separate measurements over time was performed in a National Cancer Institute (NCI) designated cancer center in the South-Central United States. The variables included sociodemographic data, cancer diagnosis, chemotherapy treatment regimens, Common Terminology Criteria for Adverse Events (CTCAE) v5.0 grade of diarrhea, stool consistency using the Bristol Stool Scale, use of antidiarrheals, associated gastrointestinal mucositis symptoms affecting QOL, and QOL measured with the Functional Assessment of Chronic Illness Therapy-Diarrhea survey.
A total of 22 participants enrolled in the study. Sixteen completed both the pre-survey and post survey. A statistically significant difference was not found between the patient's subjective report of quality of life when comparing pre and post survey responses. There was a statistically significant improvement from baseline in the QOL questions specific to bowel concerns due to diarrhea with a mean pre-survey response score of 35.3 versus a post survey score of 29.2 (p = .003). There was a reduction in the CTCACE grade of diarrhea demonstrating a reduction in the frequency of stools per day (p = .001) and a change in the consistency of stools moving from watery to more formed stools using the Bristol Stool Scale (p = .049).
Use of AA-ORS in this study was found to be useful in the reduction of CRD in patients receiving systemic oncology therapies. This study needs to be replicated with a larger, more inclusive sample size to further support the use of AA-ORS in the reduction of CRD and QOL.
本研究旨在评估一种名为Enterade®的专利氨基酸口服补液溶液(AA-ORS)在减轻化疗相关性腹泻(CRD)严重程度、改善患者报告的生活质量(QOL)、减少治疗中断、延迟、剂量调整、预防体重减轻以及主观改善相关胃肠道黏膜炎身体症状方面的效果。
在美国中南部一家美国国立癌症研究所(NCI)指定的癌症中心,对单一人群进行了一项非随机的实验性试点研究,随时间进行了两次单独测量。变量包括社会人口统计学数据、癌症诊断、化疗治疗方案、不良事件通用术语标准(CTCAE)v5.0腹泻分级、使用布里斯托大便分类法的大便稠度、止泻药的使用、影响生活质量的相关胃肠道黏膜炎症状,以及使用慢性病治疗功能评估-腹泻调查来测量生活质量。
共有22名参与者纳入该研究。16人完成了调查前和调查后的全部内容。比较调查前和调查后的回复时,患者生活质量的主观报告之间未发现统计学上的显著差异。因腹泻导致的肠道问题特定生活质量问题从基线有统计学上的显著改善,调查前平均回复分数为35.3,而调查后分数为29.2(p = 0.003)。腹泻的CTCAE分级有所降低,表明每天排便频率降低(p = 0.001),并且使用布里斯托大便分类法,大便稠度从水样变为更成形的大便(p = 0.049)。
本研究发现,AA-ORS在接受全身肿瘤治疗的患者中,对于减轻CRD是有用的。本研究需要以更大、更具包容性的样本量进行重复,以进一步支持AA-ORS在减轻CRD和改善生活质量方面的应用。