恶性肿瘤同步放化疗患者的营养状况及其影响因素

Nutritional status of patients undergoing concurrent chemoradiotherapy for malignant tumor and its influencing factors

目的调查恶性肿瘤同步放化疗患者营养状况并分析其影响因素。方法以自设问卷方式收集2019年3-5月于北京大学肿瘤医院行同步放化疗恶性肿瘤患者的相关临床资料。采用患者参与主观整体评估量表(PG-SGA)评估患者的营养状况,并分析其影响因素。结果共收回有效问卷150份。150例患者的PG-SGA评分中位数为6.0(3.0,11.0)分。56例(37.3%)患者重度营养不良,49例(32.7%)患者中度营养不良。单因素分析显示,老年、食管癌或头颈部肿瘤、Ⅳ期、放疗次数>15次、化疗次数>4次、紫杉醇+铂或铂类单药治疗方案是患者营养不良的影响因素(Z=-3.839~-2.087,P<0.05)。二元logistic回归分析显示,老年、食管癌或头颈部肿瘤、放疗次数>15次是患者重度营养不良的独立危险因素(P<0.05)。结论恶性肿瘤同步放化疗患者营养不良比例高,尤其是老年、食管癌或头颈部肿瘤、同步放化疗后期患者。医务人员应动态评估、监测患者营养状况,并及时干预。

Objective To investigate the nutritional status of patients undergoing concurrent chemoradiotherapy for malignant tumor and its influencing factors.Methods A self-designed questionnaire was used to collect related clinical data of the patients who underwent concurrent chemoradiotherapy for malignant tumor in Beijing Cancer Hospital from March to May,2019.Patient-generated Subjective Global Assessment(PG-SGA)was used to investigate the nutritional status of these patients and related influencing factors.Results A total of 150 usable questionnaires were collected.The median PG-SGA score was 6.0(3.0,11.0)for all 150 patients.Among these 150 patients,56(37.3%)had severe malnutrition and 49(32.7%)had moderate malnutrition.The univariate analysis showed that old age,esophageal cancer or head and neck cancer,stageⅣtumor,more than 15 sessions of radiotherapy,more than 4 sessions of chemotherapy,and paclitaxel+platinum regimen or platinum monotherapy were influencing factors for malnutrition in these patients(Z=-3.839——2.087,P<0.05).The binary logistic regression analysis showed that old age,esophageal cancer or head and neck cancer,and more than 15 sessions of radiotherapy were independent risk factors for severe malnutrition in patients(P<0.05).Conclusion There is a relatively high proportion of patients with malnutrition among the patients undergoing concurrent chemoradiotherapy for malignant tumor,especially among elderly patients,patients with esophageal cancer or head and neck cancer,and patients in the late stage of concurrent chemoradiotherapy.Medical staff should dynamically assess and monitor the nutritional status of patients and give timely intervention.