Ann Ital Chir. 2023;94:73-81.
Rectal cancer is one of the most common gastrointestinal malignancies, and most cases include locally advanced cancers at the time of diagnosis (stage II/III).
The purpose of this study is to observe the dynamic changes in the nutritional status of patients with locally advanced rectal cancer during concurrent radiation therapy and chemotherapy and to evaluate the nutritional risk and incidence of malnutrition in these patients.
A total of 60 patients with locally advanced rectal cancer were enrolled in this study. The 2002 Nutritional Risk Screening and Patient-Generated Subjective Global Assessment Scales (PG-SGA) were used to assess nutritional risk and status. The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (QLQ) - C30 and QLQ-CR38 scales were used for the quality of life evaluation. Toxicity was evaluated using the CTC 3.0 standard.
The incidence of nutritional risk among these 60 patients was 38.33% (23 of 60) before and 53% (32 of 60) after concurrent chemo-radiotherapy. There were 28 patients in the well-nourished group, with a PG-SGA score of <2 points, and 17 patients in the nutrition-changed group, with a PG-SGA score of <2 points before and 2 points during and after chemo-radiotherapy. In the well-nourished group, the incidence of nausea, vomiting and diarrhea mentioned in the summary was lower and the expectations for the future (according to the QLQ-CR30 and QLQ-CR28 scales) were higher than in the undernourished group. The undernourished group required delayed treatment more often and experienced nausea, vomiting and diarrhea earlier and for longer than the well-nourished group. These results show that the quality of life of the well-nourished group was better.
There is a degree of nutritional risk and deficiency in patients with locally advanced rectal cancer. Chemoradiotherapy increases the incidence of nutritional risk and deficiencies.
Enteral nutrition, Colorectal neoplasms, Quality of life, Chemo-radiotherapy, EORTC.
直肠癌是最常见的胃肠道恶性肿瘤之一，大多数病例在诊断时已处于局部晚期（Ⅱ/Ⅲ期）。
本研究旨在观察局部晚期直肠癌患者同步放化疗过程中营养状况的动态变化，并评估患者的营养风险和营养不良发生率。
共纳入 60 例局部晚期直肠癌患者。采用 2002 年营养风险筛查和患者主观整体评估量表（PG-SGA）评估营养风险和状态。采用欧洲癌症研究与治疗组织生命质量核心问卷（QLQ）-C30 及 QLQ-CR38 量表进行生活质量评估。采用 CTC3.0 标准评价毒性。
60 例患者同步放化疗前营养风险发生率为 38.33%（23/60），同步放化疗后为 53%（32/60）。营养良好组 28 例，PG-SGA 评分<2 分，营养改变组 17 例，PG-SGA 评分<2 分，同步放化疗中、后均为 2 分。营养良好组恶心、呕吐和腹泻发生率较低，对未来的期望（根据 QLQ-CR30 和 QLQ-CR28 量表）较高，营养不良组较营养良好组更早、更长时间出现恶心、呕吐和腹泻，需要延迟治疗。这些结果表明营养良好组的生活质量更好。
局部晚期直肠癌患者存在一定程度的营养风险和不足，放化疗会增加营养风险和不足的发生率。
肠内营养；结直肠肿瘤；生活质量；放化疗；EORTC。
