The impact of nutritional therapy on patients with locoregionally advanced nasopharyngeal carcinoma / 中华临床营养杂志

ABSTRACT

Objective To evaluate the impact of nutritional therapy during radiotherapy for patients with locoregionally advanced (Ⅲ-ⅣB) nasopharyngeal carcinoma (NPC) and identify factors that might influence nutritional status of the patients.Methods We retrospectively reviewed 117 patients with locoregionally advanced NPC (Ⅲ-ⅣB) treated with radical radiotherapy between December 2015 and March 2016 at Zhejiang Cancer Hospital.The patients were grouped into those who received nutritional therapy and those who did not during radiotherapy.Chi-square test was used for both inter-and intra-group comparison of nutritional status before (T0),during (T1) and after radiotherapy (T3).The patients were then grouped into those who experienced substantial weight loss (＞5％) and those who did not (≤5％),and Logistic regression was used to analyze factors that were potentially correlated with weight loss.Results Nutritional indicators were all on the decrease (T2 vs.T0,T1 vs.T0,P＜0.001),including weight,body mass index (BMI),albumin,pre-albumin (PA),and prognostic nutritional index (PNI).There was no significant difference between the group who received nutritional therapy and the one who did not in weight,albumin,PA,and PNI at a given time point (P＞ 0.05),but patients in nutritional therapy group completed radiotherapy in fewer days than those in the control group (45.8 d vs.46.0 d,P=0.023).Logistic regression revealed that patients with radiation-induced oral mucositis of grade≥3 (Odds ratio=3.232,P=0.021,95％ CI=1.198-8.820) and drop of pre-albumin by ＞15％ (Odds ratio=2.442,P=0.041,95％ CI=1.036-5.757) had greater risk of developing nutritional impairment.Conclusions Radiation-induced oral mucositis of grade≥3 might lead to deteriorating nutritional impairment in patients with locoregionally advanced NPC during radiotherapy,and drop of pre-albumin by ＞ 15％ was correlated with weight loss.Current nutritional support fell short of improving nutritional impairment during radiotherapy.