Comparison Analysis Between Nutritional Risk Screening 2002 And Subjective Globe Assessment In Locally Advanced Nasopharyngeal Carcinoma Patients With Concurrent Chemotherapy And Radiotherapy

Over 60% of Nasopharyngeal Carcinoma patients were diagnosed when the tumor at a late stage, conurrent rdiotherapy and chemotherapy is the mainly treatment for the advanced nasopharyngeal carcinoma patients. About 70%-80% of patients can be cured by concurrent chemotherapy and radiotherapy who with locally advanced nasopharyngeal carcinoma, but the side effects of treatment can cause worser nutritional status of patients to affect the therapeutic effect.NRS2002 not only can screen for nutritional deficiencies for head and neck cancer, but also be used to screen nutritional risk. PG-SGA is the nutritional status assessment methodology which designed specifically for cancer patients, and also an effective tool to assess specific nutritional status. Therefore, we need a reasonable nutritional assessment tool for NPC patients which we can timely offer reasonable nutritional support and recuperate. In this study, we use NRS2002 and PG-SGA for nasopharyngeal carcinoma patients to compare before and after concurrent radiotherapy and chemotherapy, and select the appropriate nutritional assessment tool for NPC patients, to provide reference for clinical practice.ObjectiveUsing NRS2002 and PG-SGA for nasopharyngeal carcinoma patients to self-compare before and after the concurrent radiotherapy and chemotherapy. Analysis and compare the changes in nutritional status of locally advanced nasopharyngeal carcinoma patients in PG-SGA and NRS2002, Screening the better nutritional assessment tool for locally advanced nasopharyngeal carcinoma patients, and supportting reference for locally advanced nasopharyngeal carcinoma who were acccpting the concurrent radiotherapy and chemotherapy.Methods45 cases of locally advanced tumors(08 staging of nasopharyngeal carcinoma, stage III, IV) after the initial treatment of patients with nasopharyngeal carcinoma in oncology department of Panyu Central Hospital for treatment from January 2015 to December 2015. All patients were nutrition screening on the first day、the fourteen day and the end of the day of concurrent radiotherapy and chemotherapy by using NRS2002 and PG-SGA questionnaire after admission. And the same morning get the Hb、WBC、 PLT-. RBC by drawing off the vein blood. And measured height and weight.ResultsUsing BMI screening the nutritional status of locally advanced nasopharyngeal carcinoma patients with concurrent chemotherapy and radiotherapy, the incidence of malnutrition on day 1, day 14, the end of the day are 11.1%,20%,33.3%, the difference is statistically significant(P <0.05).The applicability rate and follow-up rate of NRS2002 and PG-SGA survey is 100%.Comparing NRS2002 and PG-SGA between neutral indicators BMI in locally advanced nasopharyngeal carcinoma before and after concurrent chemotherapy and radiotherapy, on the first day of concurrent chemotherapy and radiotherapy, the malnutrition rate between BMI and PG-SGA, NRS2002 is not statistically significant (P> 0.05);on the fourteen day and the end of the day, the malnutrition rate is statistically significant (P<0.05).And the malnutrition rate of NRS2002 and PG-SGA are higher than the BMI. Prompting that NRS2002 and PG-SGA are better than BMI in locally advanced nasopharyngeal carcinoma with concurrent chemotherapy and radiotherapy.The malnutrition rate of NRS2002 screening of day 1、day14、the end of the day is 2.2%、40.0%、95.6%; the malnutrition rate of PG-SGA is 8.9%、 71.1% and 100%. The malnutrition rate of NRS2002 and PG-SGA before and after concurrent chemotherapy and radiotherapy in locally advanced nasopharyngeal carcinoma patients is statistically significant (P<0.05). On the first day and the end of the day, the difference between PG-SGA and NRS2002 is not statistically significant (P> 0.05). On the fourteen day, the difference between PG-SGA and NRS2002 is statistically significant (P<0.05). Using ROC curve analysis between NRS2002 and PG-SGA, the area under the curve of PG-SGA evaluation is larger than the NRS2002 screening. Promping that PG-SGA is better to reflect the nutritional status of patients with locally advanced nasopharyngeal carcinoma than NRS2002.On day 1、day 14、the end of the day of ocally advanced nasopharyngeal carcinoma patients with concurrent chemotherapy and radiotherapy, we can see that Hb, WBC, RBC, PLT, LY, BMI, Wt indicators status a downward trend along with the gradual deterioration of nutritional, the difference is statistically significant (P<0.01, P<0.05). Prompting that each clinical indicators shows a downward trend with the change of the nutritional status.Conclusion1 Both NRS2002 and PG-SGA are feasible in screening under nutrition in patients with nasopharyngeal carcinoma by radiotherapy and chemotherapy, but the positive rate of PG-SGA is higher, and a larger area under the ROC curve, is more suitable for nasopharyngeal carcinoma and nutrition risk screening, PG-SGA is the preferred tool in patients of locally advanced nasopharyngeal carcinoma with concurrent chemotherapy in nutrition risk screening.2 We should pay more attention on the changes of patient’s weight、BMI、 hemoglobin、white blood cells、platelets、red blood cells、lymphocyte and so on except the nutritional status of the assessment and screening of locally advanced nasopharyngeal carcinoma patients with concurrent chemotherapy.