Fan Xiaomei, Cui Huixia, Peng Haibo, Liu Shasha, Jiang Li
Clinical Medical College, Chengdu Medical College, Chengdu, China.
The First Affiliated Hospital of Chengdu Medical College, Chengdu, China.
Front Nutr. 2025 Apr 15;12:1503294. doi: 10.3389/fnut.2025.1503294. eCollection 2025.
Radiotherapy serves as the primary treatment for patients with nasopharyngeal carcinoma (NPC). However, it frequently results in a progressive decline in nutritional status, which is linked to unfavorable clinical outcomes. This study aims to evaluate the effects of an evidence-based nutritional support program on nutritional status, radiotherapy-related side effects, and quality of life (QoL) in NPC patients undergoing radiotherapy.
A historical control trial was conducted. Patients with NPC admitted between May 2023 and August 2023 were allocated to the control group and received routine care, whereas those admitted between September 2023 and December 2023 were assigned to the intervention group and provided with a multidisciplinary, professional, individualized, and comprehensive evidence-based nutritional support program. Nutritional status was assessed through anthropometric measurements (e.g., body mass index, BMI), laboratory indicators (hemoglobin and albumin levels), the Nutritional Risk Screening 2002 (NRS2002), and the Patient-Generated Subjective Global Assessment (PG-SGA). Additionally, radiotherapy-related side effects, radiotherapy interruption rates, and QoL were monitored.
Both groups comprised 40 patients each. By the conclusion of radiotherapy, a decline in nutritional status was observed in both groups; however, BMI was higher in the intervention group (23.14 ± 2.62) compared to the control group (21.38 ± 2.73). The NRS2002 score (2.73 ± 1.45) and PG-SGA score (6.13 ± 3.22) in the intervention group were significantly lower than in the control group (3.33 ± 1.16 and 7.73 ± 2.72, respectively; < 0.05). The incidence of severe malnutrition was significantly lower in the intervention group (52.5%) compared to the control group (75%) ( < 0.05). Albumin and hemoglobin levels were significantly higher in the intervention group (albumin: 120.75 ± 16.52 vs. 113.50 ± 12.08, = 0.028; hemoglobin: 41.24 ± 4.54 vs. 37.62 ± 5.04, = 0.001). The severity of radiotherapy-related side effects, including radiation-induced oral mucositis, dermatitis, and myelosuppression, was significantly lower in the intervention group ( < 0.05). All patients completed radiotherapy, and no significant difference was observed in radiotherapy interruption rates between groups (control group: 6 interruptions; intervention group: 1 interruption; > 0.05). Post-radiotherapy QoL scores demonstrated that the intervention group achieved superior outcomes in physical, role, emotional, cognitive, and social functioning ( < 0.05).
Implementing evidence-based nutritional support programs has the potential to prevent the decline in nutritional status among NPC patients receiving radiotherapy, reduce the occurrence of treatment-related side effects, and enhance overall quality of life.
放射治疗是鼻咽癌（NPC）患者的主要治疗方法。然而，它常常导致营养状况逐渐下降，这与不良的临床结局相关。本研究旨在评估一项基于证据的营养支持计划对接受放射治疗的NPC患者营养状况、放疗相关副作用及生活质量（QoL）的影响。
进行一项历史对照试验。2023年5月至2023年8月收治的NPC患者被分配至对照组，接受常规护理；而2023年9月至2023年12月收治的患者被分配至干预组，并接受多学科、专业、个性化且全面的基于证据的营养支持计划。通过人体测量指标（如体重指数，BMI）、实验室指标（血红蛋白和白蛋白水平）、2002年营养风险筛查（NRS2002）以及患者主观整体评定法（PG-SGA）评估营养状况。此外，监测放疗相关副作用、放疗中断率及生活质量。
两组各有40例患者。到放疗结束时，两组患者的营养状况均出现下降；然而，干预组的BMI（23.14±2.62）高于对照组（21.38±2.73）。干预组的NRS2002评分（2.73±1.45）和PG-SGA评分（6.13±3.22）显著低于对照组（分别为3.33±1.16和7.73±2.72；P<0.05）。干预组严重营养不良的发生率（52.5%）显著低于对照组（75%）（P<0.05）。干预组的白蛋白和血红蛋白水平显著更高（白蛋白：120.75±16.52 vs. 113.50±12.08，P=0.028；血红蛋白：41.24±4.54 vs. 37.62±5.04，P=0.001）。干预组放疗相关副作用的严重程度，包括放射性口腔黏膜炎、皮炎和骨髓抑制，显著更低（P<0.05）。所有患者均完成放疗，两组间放疗中断率无显著差异（对照组：6例中断；干预组：1例中断；P>0.05）。放疗后生活质量评分表明，干预组在身体、角色、情感、认知和社会功能方面取得了更好的结果（P<0.05）。
实施基于证据的营养支持计划有可能预防接受放疗的NPC患者营养状况下降，减少治疗相关副作用的发生，并提高整体生活质量。
