头颈部癌症患者放射治疗期间营养相关症状与去脂体重变化的关系

Relationship between nutrition impact symptoms and fat-free mass in patients with head and neck cancer during radiotherapy

目的观察头颈部癌症(head and neck cancer,HNC)患者放射治疗期间营养相关症状(nutrition impact symptoms,NIS)和去脂体重变化并分析两者之间的关系。方法采用便利抽样法,选取2017年3月至2020年1月于北京市某肿瘤医院头颈放疗科门诊接受放射治疗的HNC患者为研究对象。于放疗前、放疗中和放疗结束时采用营养相关症状审核表评估营养相关症状,采用生物电阻抗法测定去脂体重,采用广义估计方程分析两者关系。结果共542例患者纳入分析,随放疗进行,HNC患者NIS个数与得分呈现增加趋势,到放疗结束时达到最高;去脂体重呈现下降趋势,到放疗结束时达到最低;NIS得分越高的患者其放疗过程中去脂体重丢失百分比越多。结论随放疗进行,HNC患者NIS得分增加,去脂体重减少,NIS得分高的患者其去脂体重丢失百分比多。提示医务人员应重视NIS管理,及时采取综合性干预措施减轻去脂体重丢失。

Objective To observe the changes of nutrition impact symptoms(NIS)and fat-free mass and analyze the relationship between them in patients with head and neck cancer(HNC)during radiotherapy.Methods A convenient sampling method was adopted to select HNC patients who received radiotherapy in the outpatient clinic of department of radiotherapy for head and neck cancer in a cancer hospital in Beijing from March 2017 to January 2020.The nutrition impact symptoms(NIS)were assessed by a nutrition impact symptoms checklist and the fat free mass was assessed by bioelectrical impedance analysis at three time points:before radiotherapy(T1),during radiotherapy(T2)and at the end of radiotherapy(T3).The Generalized Estimating Equations(GEE)was used to analyze the relationship between them.Results A total of 542 HNC patients were included in the analysis.During radiotherapy,the patients'NIS number and score presented an increasing trend,reaching the highest level and peaked at the end of radiotherapy.The change of fat-free mass showed a decreasing trend and reached the minimum at the end of radiotherapy.Patients with higher NIS scores had more percentage loss of fat-free mass.Conclusions During radiotherapy,patients with HNC showed an increase in NIS score and lost fat-free mass.Patients with higher NIS score lost more percentage of fat-free mass,which suggested that clinical medical staff should pay attention to NIS management and take comprehensive intervention measures in time to reduce the loss of fat-free mass.