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营养干预对接受术后化疗的结直肠癌患者化疗耐受性及生活质量的影响:一项随机对照研究

Effect of Nutritional Intervention on Chemotherapy Tolerance and Quality of Life in Patients with Colorectal Cancer Undergoing Postoperative Chemotherapy: A Randomized Controlled Study.

作者信息

Wang Jiwei, Huang Yong, Zheng Xilan, Xie Ming, Wu Yin, Yang Li, Yin Chunmei

机构信息

Department of General Surgery, Digestive Disease Hospital, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China.

Day Chemotherapy Ward, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China.

出版信息

Nutr Cancer. 2025;77(3):414-423. doi: 10.1080/01635581.2025.2449719. Epub 2025 Jan 9.

Abstract

This study explored the effect of symptom-based individualized nutritional intervention on chemotherapy tolerance and quality of life (QOL) in patients with colorectal cancer (CRC) undergoing postoperative chemotherapy. Postoperative patients with CRC ( = 88) were randomly assigned to the control group (CG,  = 45) and intervention group (IG,  = 43) receiving conventional diet counseling and symptom-based individualized nutritional intervention, respectively, and chemotherapy tolerance, adverse effects, and QOL were compared. Participants in the IG exhibited better nutritional status at the last chemotherapy cycle, with lower Nutrition Risk Screening 2002 (2.37 ± 0.65 vs. 3.78 ± 0.65,  < 0.01) and Patient-Generated Subjective Global Assessment (6.26 ± 0.76 vs. 7.78 ± 0.70,  < 0.01) scores. Compared with CG, relative dose intensity reduction (9.3% vs. 25.89%,  = 0.02), chemotherapy regimen change (25.58% vs. 53.33%,  < 0.01), and chemotherapy delay (13.95% vs. 35.56%,  = 0.019) were lower in the IG. Nausea/vomiting (2.33% vs. 17.78%,  = 0.017), thrombocytopenia (2.33% vs. 28.89%,  < 0.01), and hand-foot syndrome (4.65% vs. 22.22%,  = 0.03) were less frequent in the IG. Participants in the IG had better QOL, with higher physical function scores at cycles 4 (67.91 ± 5.22 vs. 62.22 ± 4.02,  < 0.01) and 8 (72.71 ± 6.31 vs. 57.63 ± 4.75,  < 0.01). Individualized nutritional interventions improved chemotherapy tolerance and QOL and reduced adverse effects in this patient cohort.

摘要

本研究探讨了基于症状的个体化营养干预对接受术后化疗的结直肠癌(CRC)患者化疗耐受性及生活质量(QOL)的影响。88例CRC术后患者被随机分为对照组(CG,n = 45)和干预组(IG,n = 43),分别接受传统饮食咨询和基于症状的个体化营养干预,比较两组的化疗耐受性、不良反应及QOL。干预组患者在最后一个化疗周期时营养状况更佳,其2002年营养风险筛查(2.37±0.65 vs. 3.78±0.65,P<0.01)及患者主观整体评定法(6.26±0.76 vs. 7.78±0.70,P<0.01)评分更低。与对照组相比,干预组的相对剂量强度降低(9.3% vs. 25.89%,P = 0.02)、化疗方案改变(25.58% vs. 53.33%,P<0.01)及化疗延迟(13.95% vs. 35.56%,P = 0.019)情况更少。干预组恶心/呕吐(2.33% vs. 17.78%,P = 0.017)、血小板减少症(2.33% vs. 28.89%,P<0.01)及手足综合征(4.65% vs. 22.22%,P = 0.03)的发生率更低。干预组患者的QOL更佳,在第4周期(67.91±5.22 vs. 62.22±4.02,P<0.01)和第8周期(72.71±6.31 vs. 57.63±4.75,P<0.01)时身体功能评分更高。个体化营养干预改善了该患者队列的化疗耐受性及QOL,并减少了不良反应。

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