Investigation And Influencing Factors Of Nutritional Status In Patients With Nasopharyngeal Carcinoma During Concurrent Chemoradiotherapy

Objective1.To investigate the dynamic change of nutritional status,sleeping status,mental state(anxiety and depression),inflammatory factor level,the degree of pain,dietary intake and treatment side effects of patients with nasopharyngeal carcinoma during concurrent chemoradiotherapy.2.To analysis the effects of social demographic data,clinical data,sleep status,mental state(anxiety and depression),inflammatory factor level,pain,dietary intake and treantment side effects to nutritional status of patients with nasopharyngeal carcinoma during concurrent chemoradiotherapy and to analysis the factors that influence the nutritional status of patients with nasopharyngeal carcinoma.Methods During October 2015 to November 2016,in Tianjin medical university affiliated tumor hospital,we selected the NPC patients who first visited and accepted the concurrent chemoradiotherapy as the research objects using the convenience sampling method.During the concurrent chemoradiotherapy,we evaluated the nutritional status,sleep status,mental state(anxiety and depression),inflammatory factor level,pain degree,dietary intake and radiation and chemotherapy side effects of patients with PG-SGA,PQSI,HADS,inflammatory cytokines questionnaire,24-hour dietary review table,NRS and digital assessment scale of radiation and chemotherapy side effects of patients weekly.Kruskal-Wallis Test was used to analyze the single influencing factors of the difference of nutritional status of patients.multiple regression analysis was used to analyze the influencing factors of nutritional status.Results A total of 159 patients who underwent concurrent chemoradiotherapy were involved into this study and 140 patients are in good nutritional status.Finally there were 130 patients left and 10 patents dropped out of the investigation.After the concurrent chemoradiotherapy,5 patients(3.8%)are in good nutritional status,65patients(50.0%)in moderate malnutrition,60 patients(46.2%)in severe malnutrition.Nutritional status of the patients as radiotherapy going on shows a tread of decline during the concurrent chemoradiotherapy.1.The single factor analysis of the influencing factors of nutritional status of NPC)during chemoradiotherapy According to the single factor analysis,the significant variables for severe malnutrition were BMI(H=2.322,P=0.041),TNM stage(H=22.557,P=0.000),chemotherapy cycle(H=11.863,P=0.003),serum prealbumin(Z=-4.844,P=0.044),energy intake per day per kg(Z=-3.027,P=0.002),depression(Z=-5.643,P=0.000),PLR(Z=-1.871,P=0.041),pain stage(Z=-2.110,P=0.035),oral mucositis(Z=-1.895,P=0.048),xerostomia(Z=-6.246,P=0.000),dysgeusia(Z=-4.956,P=0.000),anorexia(H=10.779,P=0.005),nausea(H=9.947,P=0.019),vomit(H=5.741,P=0.045),leucocyte level(H=3.666,P=0.047).2.The multiple logistic analysis of the influencing factors of nutritional status of NPC during chemoradiotherapy According to multiple regression analysis,clinical stages,depression,xerostomia,anorexia,dysgeusia,nausea and energy intake are the significant influencing factors of mutrition status of patients with nasopharyngeal carcimo during concurrent chemoradiotherapy.Conclusion The nutritional status of patients shows a decreased tread as a whole as radiotherapy going on.For the patients with late cinic stage,depression,high level of xerostomia,dysgeusia,anorexia,vomit and low energy intake should be given early malnutrition screening and nutritional intervention.