直肠癌患者新辅助放化疗期间营养状况调查分析

Nutritional status assessment in rectal cancer patients undergoing neoadjuvant chemoradiotherapy

目的了解直肠癌患者新辅助放化疗期间的营养状况及变化规律,为制定有效的管理方案提供参考。方法对66例直肠癌新辅助放化疗患者,采用营养风险筛查量表、患者主观整体评估量表于放疗定位时、开始放疗及放疗第1~5周7个时间点进行测评。结果体质量随治疗进程而下降(P<0.01);33.3%~57.6%患者存在营养风险,中、度重营养不良分别为18.2%~54.5%及0~34.8%;发生体质量丢失51例(77.3%);同步双药化疗者体质量丢失率显著高于单药化疗者(P<0.01);体质量丢失明显者放化疗不耐受率显著高于体质量丢失较轻者(P<0.01)。结论直肠癌患者放化疗前即存在营养风险,随治疗进程重度营养不良者增多,导致其难以耐受治疗。应制定针对性干预方案,改善患者营养状况,确保放化疗的顺利实施。

Objective To describe nutritional status and its changing trends in rectal cancer patients undergoing neoadjuvant chemoradiotherapy,and to provide reference for effective management.Methods Sixty-six rectal cancer patients undergoing neoadjuvant chemoradiotherapy were assessed using the Nutritional Risk Screening 2002（NRS-2002） and Patient-Generated Subjective Global Assessment（PG-SGA）at CT simulation for radiotherapy treatment planning,the beginning of radiotherapy treatment and once a week during the treatment period.Results Body weights decreased along with the treatment（P〈0.01）.Strictly,33.3% to 57.6% of patients had nutritional risk.Moderate malnutrition was observed in 18.2%-54.5% of patients and severe malnutrition in 0-34.8% of patients.Fifty-one patients（77.3%） experienced weight loss.The rate of weight loss was significantly higher in patients who received two chemotherapeutic agents than those received single regimen（P〈0.01）.The more severe weight loss,the higher rate of dropout of the treatment（P〈0.01）.Conclusion Rectal cancer patients have nutritional risk before chemoradiotherapy.As the treatment goes on,more patients develop malnutrition,resulting in poor tolerance of treatment.A targeted intervention program should be formulated to improve nutritional status of patients and facilitate implementation of chemoradiotherapy.