鼻咽癌病人调强放疗过程中营养状况变化和生活质量的关系

Correlation of nutritional status and quality of life in patients with nasopharyngeal carcinoma during intensity-modulated radiotherapy

[目的]探讨鼻咽癌(nasopharyngeal carcinoma,NPC)病人在调强放疗(intensity-modulated radiotherapy,IMRT)过程中营养状况的变化和生活质量的关系。[方法]分别于基线、放疗结束收集鼻咽癌病人在放疗过程中的营养相关参数、营养筛查评分结果和病人的生活质量评分,探讨鼻咽癌放疗病人营养状况的变化规律及其与生活质量间的关系。[结果]经单因素分析和多因素Logistic分析得出放疗前后体重丢失是病人放疗后营养不良的独立危险因素[OR=3.048,95%CI(1.391,6.682)],ROC曲线下面积AUC=0.939,灵敏度性84.9%,特异性为100%。此外,放疗前后体重减轻和便秘、食欲减退、社交困难和体重丢失评分呈负相关。[结论]放化疗严重影响鼻咽癌病人的营养状况,受影响最大的营养参数是体重减轻的程度。营养状况与生活质量密切相关,应尽早介入营养干预,控制病人体重下降的趋势,改善病人便秘、食欲减退和进食的情况。

Objective:To investigate the correlation of nutritional status and quality of life during intensity-modulated radiotherapy(IMRT)in patients with nasopharyngeal carcinoma(NPC).Methods:Data on nutritional status and quality of life were collected at the baseline,at the end of radiotherapy.The data were analyzed for possible correlations between nutritional status and quality of life.Results:Univariate and multivariate logistic analysis showed that weight loss was independent risk factor for nutritional status in patients with nasopharyngeal carcinoma after therapy[OR=3.048,95%CI(1.391,6.682)].The sensitivity and specificity of weight loss in predicting nutritional status were 84.9%and 100%respectively,the area under the ROC curve was 0.939.Furthermore,weight loss was negatively correlated with constipation,loss of appetite,difficulties in social interaction and weight loss scores.Conclusions:The nutritional status of nasopharyngeal carcinoma patients was seriously affected by chemoradiotherapy,and the most affected nutritional parameter was the degree of weight loss.Nutritional status was closely related to the quality of life.It was necessary to intervene in nutrition as early as possible to control the trend of weight loss of patients and improve constipation,loss of appetite and eating.