多学科团队营养管理对鼻咽癌患者营养及毒性状态的影响。
The impact of multidisciplinary team nutrition management on nutritional and toxicity status in patients with nasopharyngeal carcinoma.
作者信息
Ou Xueqing, Chen Hui, Qiu Ting, Yuan Yajun, Gong Xiaohua
机构信息
Department of Cancer Center, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China.
Guangdong Provincial Key Laboratory of Biomedical Imaging, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China.
出版信息
Asia Pac J Oncol Nurs. 2023 Apr 16;10(7):100237. doi: 10.1016/j.apjon.2023.100237. eCollection 2023 Jul.
OBJECTIVE
To explore the impact of multidisciplinary team (MDT) nutrition management on the nutritional and toxicity status of patients with nasopharyngeal carcinoma undergoing chemoradiotherapy.
METHODS
A total of 104 patients undergoing chemoradiotherapy for nasopharyngeal carcinoma admitted to our hospital from July 2018 to February 2021 were retrospectively enrolled, including who received conventional nutrition management (the routine group, = 52) and who received MDT nutrition management (the experimental group, = 52). Nutritional indicators (dietary intake, body mass index, serum albumin, serum prealbumin, hemoglobin, total lymphocyte count, serum transferrin [TRF]), the Nutrition Risk Screening 2002 (NRS2002) score and acute toxicity level were recorded before, during, and after chemoradiotherapy. Multiple regression analysis was performed to identify nutritional risk indicators.
RESULTS
During and after chemoradiotherapy, the body mass index, albumin, prealbumin, hemoglobin, total lymphocyte count, TRF, dietary intake, number of patients with an NRS2002 score < 3, and acute toxicity score in the experimental group improved compared to those in the routine group ( < 0.05). Concurrent chemotherapy, the NRS2002 score and a half-diet strategy were independent factors affecting the nutritional status of nasopharyngeal carcinoma patients who underwent chemoradiotherapy.
CONCLUSIONS
Active screening and evaluation of the nutritional status of patients with nasopharyngeal carcinoma during chemoradiotherapy as well as MDT nutrition management can be used to detect nutritional problems, thus improving quality of life and reducing related toxicity.
目的
探讨多学科团队（MDT）营养管理对接受放化疗的鼻咽癌患者营养状况及毒性反应的影响。
方法
回顾性纳入2018年7月至2021年2月我院收治的104例接受放化疗的鼻咽癌患者，其中接受传统营养管理的患者为常规组（n = 52），接受MDT营养管理的患者为试验组（n = 52）。记录放化疗前、放化疗期间及放化疗后的营养指标（饮食摄入量、体重指数、血清白蛋白、血清前白蛋白、血红蛋白、总淋巴细胞计数、血清转铁蛋白[TRF]）、营养风险筛查2002（NRS2002）评分及急性毒性反应程度。进行多元回归分析以确定营养风险指标。
结果
放化疗期间及放化疗后，试验组的体重指数、白蛋白、前白蛋白、血红蛋白、总淋巴细胞计数、TRF、饮食摄入量、NRS2002评分<3的患者数量及急性毒性反应评分均较常规组有所改善（P<0.05）。同步化疗、NRS2002评分及半流质饮食策略是影响接受放化疗的鼻咽癌患者营养状况的独立因素。
结论
在鼻咽癌患者放化疗期间积极筛查和评估其营养状况以及实施MDT营养管理，可发现营养问题，从而提高生活质量并降低相关毒性反应。
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