口服营养补充对鼻咽癌同期放化疗患者的影响被引量：19

Effect of oral nutritional supplements on nutritional status and quality of life in patients with nasopharyngeal carcinoma receiving chemoradiotherapy

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摘要背景与目的:鼻咽癌患者同步放化疗期间常出现体质量下降及营养不良,进而影响治疗疗效及生活质量。本研究旨在对其进行强化营养咨询和口服营养补充(oral nutritional supplements,ONS),观察对营养状况及生活质量的影响。方法:采用前瞻性、随机对照的方法,以2014年6月—2015年12月在复旦大学附属肿瘤医院放疗科和上海交通大学附属第九人民医院放疗科64例鼻咽癌同期放化疗患者作为研究对象。试验组给予个体化营养咨询和口服营养补充,对照组给予常规治疗。采用生物电阻抗方法及PG-SGA营养评估法,观察营养干预对鼻咽癌同期放化疗患者的营养状况患者主观整体评估(patient-generated subjective global assessment,PG-SGA)评分及人体成分指标,如体质量、体质指数、脂肪组织、去脂组织、体细胞量、骨骼肌量及相位角的影响。结果:同步放化疗期间所有患者人体成分指标均有不同程度的下降,下降程度试验组均好于对照组(P>0.05);PG-SGA营养评估的评分值,试验组均低于对照组(P>0.05);生活质量各项评分,试验组均好于对照组(P>0.05);ONS摄入量大于2/3计划量的患者与对照组相比,人体成分指标如去脂组织指数和骨骼肌量试验组明显好于对照组(P<0.05);生活质量评分指标如总体健康状况、恶心与呕吐、疼痛及便秘的平均变化值,试验组均小于对照组(P>0.05)。结论:鼻咽癌患者放化疗期间营养状况下降明显,及时给予口服营养补充可在一定程度上缓解营养状况的进一步下降。 Background and purpose： Weight loss and malnutrition are very common in nasopharyngeal carcinoma（NPC） patients undergoing concurrent chemoradiotherapy（CCRT）, leading to impaired curative effect of the therapy and the quality of life（QOL）. This study aimed to examine the effect of intensive nutrition counseling and oral nutritional supplements（ONS） on nutritional status and QOL. Methods： A prospective, randomized and comparative study was performed from Jun. 2014 to Dec. 2015 at two centers（n=64）. The ONS group was given the intensive nutrition and ONS, whereas the control was given the usual care. Body composition parameters were obtained weekly from baseline until the end of treatment. The nutritional status of all patients was evaluated by the patient-generated subjective global assessment（PG-SGA）. Results： There was significant deterioration in body composition parameters, PG-SGA value and QOL during CCRT, and the ONS group is better than the control group（P〈0.05）. Fat-free mass index（FFMI） and skeletal muscle mass（SM） were significantly better in patients with ONS intake 2/3 planed than in the control group（P〈0.05）. The ONS intake 2/3 planed group had better mean value in global QOL, nausea and vomiting, pain, and constipation（P〉0.05）. Conclusion： In this study, we have shown that intensive nutrition counseling and ONS may be beneficial to NPC patients with enough supplements intake during CCRT.