Imajima Takashi, Shirakawa Tsuyoshi, Ohtsu Yasuyuki, Uchihashi Hitomi, Otsuka Taiga, Akashi Koichi, Baba Eishi, Mitsugi Kenji
Department of Medical Oncology, Sasebo Kyosai Hospital, Nagasaki, Japan.
Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.
Cancer Diagn Progn. 2024 Jul 3;4(4):503-509. doi: 10.21873/cdp.10355. eCollection 2024 Jul-Aug.
BACKGROUND/AIM: Physical decline is accompanied with malnutrition in advanced cancer patients, thus nutritional care is often provided with cancer rehabilitation. However, a limited number of studies have focused on which nutritional index serves as an important marker to provide more intensive nutritional support for patients.
We retrospectively reviewed advanced cancer patients who received chemotherapy and rehabilitation during hospitalization. In analysis 1, patients were divided into two groups: a Well group with caloric intake ≥ basal metabolism, calculated by the Harris-Benedict equation, and a Poor group with caloric intake less than their basal energy expenditure. The primary endpoint was the ratio of patients whose Eastern Cooperative Oncology Group Performance Status (ECOG PS) or Barthel index (BI) was maintained during rehabilitation. In analysis 2, the cohort was restratified into Responders, whose ECOG PS and BI improved, and Non-responders, comprising the remaining patients. Several nutritional indices were compared between the groups.
Eighty-four patients were evaluated in analysis 1, namely 51 Well patients and 33 Poor patients. The ECOG PS-maintained rate was 98% and 91% (p=0.29), and the BI-maintained rate was 100% and 88% (p=0.02) in the Well and Poor groups, respectively. In analysis 2, 72 patients were evaluated after excluding 12 patients who lacked nutritional data after rehabilitation. Compared with the Responders group, caloric intake appeared worse in the Non-responders group, although their nutritional background tended to be better.
Insufficient caloric intake might be a predictive marker of poor outcomes after rehabilitation in advanced cancer patients.
背景/目的:晚期癌症患者身体机能下降常伴有营养不良,因此营养护理常与癌症康复一起提供。然而,仅有少数研究关注哪种营养指标可作为为患者提供更强化营养支持的重要标志物。
我们回顾性分析了住院期间接受化疗和康复治疗的晚期癌症患者。在分析1中,患者被分为两组:热量摄入≥根据哈里斯-本尼迪克特方程计算的基础代谢量的良好组,以及热量摄入低于基础能量消耗的较差组。主要终点是康复期间东部肿瘤协作组体能状态(ECOG PS)或巴氏指数(BI)维持不变的患者比例。在分析2中,队列重新分层为ECOG PS和BI改善的反应者,以及其余患者组成的无反应者。比较了两组之间的几种营养指标。
分析1中评估了84例患者,即51例良好组患者和33例较差组患者。良好组和较差组的ECOG PS维持率分别为98%和91%(p = 0.29),BI维持率分别为100%和88%(p = 0.02)。在分析2中,排除12例康复后缺乏营养数据的患者后,评估了72例患者。与反应者组相比,无反应者组的热量摄入似乎较差,尽管他们的营养背景往往更好。
热量摄入不足可能是晚期癌症患者康复后预后不良的预测指标。