Study On The Influencing Factors Of Nutritional Status Of Patients With Nasopharyngeal Carcinoma

Objectives:1. To clarify the nutrition, dietary intake, pain degree, radiotherapy adverse reactions and psychological status of patients with nasopharyngeal carcinoma before and after radiotherapy and their corresponding trends.2.To analyze the effect of radiotherapy in nasopharyngeal carcinoma patients withgeneral information, dietary intake, degree of pain, radiotherapy adverse reaction and psychological state of their nutritional status and to explore the influencing factors of nutritional status of patients with nasopharyngeal carcinoma during radiotherapy, to provide a scientific basis for making clinical nutritional intervention program.Methods:The patients were selected from December 2015 to December 2016 in the Third Affiliated Hospital of Kunming Medical University to meet the conditions of nasopharyngeal carcinoma radiotherapy patients, using the method of self-control,using the same questionnaire to investigate general information of patients, The contents include: gender, age, residence, family per capita income, occupation,marital status, educational level, past medical history, smoking and drinking history,TNM stage,pathological type,chemotherapy history,radiotherapy and dose. The nutritional status, dietary intake, pain degree, radiotherapy adverse reaction and psychological status were investigated before radiotherapy,radiotherapy for 4 weeks and after radiotherapy. To evaluate and analyze the nutritional status of nasopharyngeal carcinoma patients and its influencing factors dynamically. Single factor analysis using X2 test, multivariate analysis using binary logistic regression model,P <0.05 was statistically significant.Results;1. A total of forty-four patients met the inclusion criteria, and eleven (25%)patients had malnutrition or nutritional risk before radiotherapy, only one patient were severe malnutrition.After radiotherapy, 73% patients were malnourished and most of them were severe malnutrition (66%).2.The results of paired t test showed that the nutritional indexes after radiotherapy, such as body mass index, serum albumin, serum prealbumin,lymphocyte count and serum transferrin,were significantly lower than those before radiotherapy (P <0.05), and the difference was statistically significant (P <0.001).3.The changes of dietary intake, anxiety and depression scores, pain scores and the incidence of adverse events of radiotherapy were statistically significant before and after radiotherapy (P <0.05).4.x2 test results show: synchronous chemotherapy, diet reduction ?1/2, depression are influencing factors of nutritional status of patients with nasopharyngeal carcinoma during radiotherapy.Logistic regression analysis showed that synchronous chemotherapy and diet reduction ?1/2 are independent influencing factors of nutritional status of patients with nasopharyngeal carcinoma during radiotherapy.Conclusions:1. The incidence of malnutrition in patients with nasopharyngeal carcinoma is high,and its nutritional status is further exacerbated after radiotherapy,and the relative nutritional indicators of patients during radiotherapy are declining.2. With the increase in the number and dose of radiotherapy, the dietary intake of patients was significantly reduced, anxiety, depression, pain scores gradually increased, the incidence of radiotherapy adverse reactions increased.3. Synchronous chemotherapy, diet reduction ? 1/2 are the independent influencing factors of nutritional status of patients with nasopharyngeal carcinoma during radiotherapy.4. Actively do a good job of screening and assessment the nutritional status of nasopharyngeal carcinoma patients before, during and after radiotherapy, particularly in patients of synchronized chemotherapy and diet reduction > 1/2, to help us to early detection of nutritional problems and implementation of effective nutrition intervention may improve the nutritional status of patients with nasopharyngeal carcinoma during radiotherapy, reduce the occurrence of malnutrition, improve the quality of life, improve the prognosis.