鼻咽癌放疗患者去脂体质量变化情况及影响因素分析

Analysis of the changes and influencing factors of the fat-free mass in patients with nasopharyngeal carcinoma undergoing radiotherapy

目的分析鼻咽癌患者放疗期间去脂体质量变化情况并探究去脂体质量变化的影响因素。方法采用便利抽样法选取2021年2月至12月四川省肿瘤医院接受放射治疗,符合纳入标准的鼻咽癌患者,于放疗前(T1)、放疗第10次(T2)、放疗第20次(T3)、放疗结束(T4)共4个时间点,采用人体成分分析仪对患者营养状况进行纵向评估并分析其变化趋势,运用广义估计方程探究去脂体质量变化的影响因素。结果共纳入106例鼻咽癌放疗患者,去脂体质量随放疗进行而不断下降,变化范围为-10.3~2 kg,T1~T2为鼻咽癌放疗患者去脂体质量丢失最多的时期,平均丢失(1.32±1.96)kg。放疗时间、肿瘤分期、接受新辅助化疗以及症状负荷是鼻咽癌放疗患者去脂体质量丢失的影响因素(P<0.05)。结论鼻咽癌患者放疗期间去脂体质量下降明显,临床医护人员应当重视放疗期间患者营养状况,关注去脂体质量的变化情况,重点评估患者放疗时间、肿瘤分期、治疗方案以及营养相关症状,及时采取相关干预措施维持良好的营养状况,确保抗肿瘤治疗的正常进行。

Objective To analyze the changes of the fat-free mass in patients with nasopharyngeal carcinoma during radiotherapy and explore the influencing factors of the changes of the fat-free mass.Methods The convenient sampling method was used to select patients with nasopharyngeal carcinoma who received radiotherapy in Sichuan Provincial Cancer Hospital from February to December 2021 and met the inclusion criteria.At four time points of before radiotherapy(T1),the 10th time of radiotherapy(T2),the 20th time of radiotherapy(T3)and the end of radiotherapy(T4),the nutritional status of the patients was evaluated longitudinally by the human body composition analyzer and the change trend was analyzed.The influencing factors of the changes of the fat-free mass were explored by the generalized estimation equation.Results A total of 106 patients with nasopharyngeal carcinoma were included in the study.The fat-free mass decreased with the radiotherapy,ranging from-10.3 to 2 kg.T1 to T2 was the period in which the fat-free mass lost the most,with an average loss of(1.32±1.96)kg.The time of radiotherapy,tumor stage,neoadjuvant chemotherapy and symptom load were the influencing factors of the loss of fat-free mass in nasopharyngeal carcinoma patients undergoing radiotherapy(P<0.05).Conclusion The fat-free mass of patients with nasopharyngeal carcinoma decreased significantly during radiotherapy.Clinical medical staff should pay attention to the nutritional status of patients during radiotherapy,pay attention to the changes in the fat-free mass,focus on evaluating the time of radiotherapy,tumor stage,treatment plan and nutrition-related symptoms of patients,and take relevant intervention measures to maintain good nutritional status in time to ensure the normal progress of anti-tumor treatment.