The Effect of Personalized Nutrition Counseling on Nutrition Status in Patients Receiving Concurrent Chemoradiotherapy for Oral Cancer

• Main Authors: Yi-Ru, Chen, 陳怡汝
• Other Authors: Feili Lo Yang
• Format: Others
• Language: zh-TW
• Published: 2014
• Online Access: http://ndltd.ncl.edu.tw/handle/47975332752948311256

碩士 === 輔仁大學 === 營養科學系碩士班 === 102 === Research indicated that patients with oral cancer, arising from the tumor location and treatment side effects, may have severe weight loss (≥10% in 6 months) before and after treatment of prevalence approximating 19%~45%. Weight loss is an important indicator for malnutrition, which will reduce tolerance and response to treatment of oral cancer patients, and will increase their risk of infection, morbidity rate, and mortality rate. However, protein and micronutrients nutritional status, which may affect the metabolism of body protein and inflammatory reaction, have great impact on patients of oral cancer during concurrent chemoradiotherapy and their recovery phase. The aim of the present study was to investigate the influence of personalized nutrition counseling on dietary intake, nutritional status, body composition, biochemical indicators and weight maintaining. Additionally, whether the compliance with therapy, and therapeutic outcome were improved by different extents of nutritional intervention was evaluated. This trial recruited 32 patients, who were randomized to control group or experimental group (personalized nutrition counseling group, PNC group). Weekly personalized nutrition counseling was provided during concurrent chemoradiotherapy (CCRT) for 6-8 weeks and one month after finish of CCRT in PNC group. In control group, only routine nutrition counseling during CCRT (6-8 weeks) was offered. The results showed that daily intake of total energy, protein and carbohydrate were significantly higher in PNC group than in control group at the 12th week after CCRT. Both groups had significantly decreased body weight, fat free mass, BMI, and the percentage of fat mass at the end of CCRT, the 4th week and the 12th week after CCRT compared with the baseline respectively. The percentage of unintended weight loss (UWL), with baseline as reference, had no significant differences between PNC and control group (6.9% vs 6.0% respectively) at the end of CCRT. However at the 4th week after CCRT the body weight became maintained in both groups. The amount of blood hemoglobin changed was significantly better in PNC group compared with the control group at the end of CCRT. Both groups presented higher marginal deficiency rates of vitamin B2 since the 4th week after CCRT. At the 4th week after CCRT, PNC group had significantly lower scores of the section A4 of PG-SGA (activity and function), indicating that PNC group had better activity and function than in control group. In conclusion, nutrition intervention during CCRT could help patients in maintaining body weight in the 12-week post-CCRT period. However, the more intensively nutrition counseling, such as weekly personalized nutrition counseling, could increase dietary intake, improve the activity and function of patient, and prevent the decrease of blood hemoglobin induced by CCRT. Patient received personalized nutrition counseling during and after CCRT may have positive effects of improved nutritional status and reduced CCRT treatment side effects.