Study On The Effect Of Oral Nutrition Supplementation During The Whole Course Of Radiotherapy For Nasopharyngeal Carcinoma

Objective:To investigate the effects of oral nutritional supplements in whole-course of radiotherapy on nutritional status,radiotherapy side effects,chemoradiotherapy compliance and quality of life during radiotherapy for nasopharyngeal carcinoma.Methods:A total of 92 cases of nasopharyngeal carcinoma with initial diagnosis radical radiotherapy/chemoradiotherapy from January 2017 to May 2018 were selected and divided into the experimental group(n=46)and the control group(n=46)according to the patient's wishes.The experimental group was treated with nutrition education and oral nutritional supplements in whole-course of radiotherapy.In the control group,only nutrition education was conducted at the beginning of radiotherapy,and nutrition treatment was given only when the score of nutrition screening was greater than or equal to 3 points.All patients were evaluated before and after radiotherapy,including PG-SGA scale,weight/weight loss rate,body mass index,triceps skin fold thickness,upper arm circumference,hemoglobin,lymphocyte,albumin,proalbumin,etc.NRS2002 nutritional screening was performed weekly during radiotherapy.Radiotherapy efficacy was evaluated according to RECIST,and side effects were evaluated according to RTOG standard at the end of radiotherapy,QLQ-C30 scale was used for quality of life assessment.All statistical analyses were performed using SPSS(version 17.0),t test was used for measurement data,and x2 test was employed for counting data.Nutritional status,radiotherapy side effect,radiotherapy and chemoradiotherapy compliance and quality of life of the two groups were respectively compared.Results:Before radiotherapy,there was no statistical difference in nutrition indexes between the two groups.Weight loss rate(2.04%vs 5.50%),PG-SGA score(7.26 vs 8.87),severe malnutrition(PG-SGA greater than 9 points)rate(21.7%vs 47.8%),oropharyngeal mucosal reaction rate(34.8%vs 56.5%)and infection rate(0.0%vs 8.7%)were significantly lower than the control group(P<0.05).Lymphocytes(0.71*109/L vs 0.55*10 9/L),albmin(43.02 g/L vs 40.99 g/L)and prealbumin(246.57 g/L vs 194.20 g/L)were significantly higher than control group(P<0.05);There was no statistical difference in body mass index,hemoglobin,triceps skin fold thickness and upper arm circumference.There is no significant difference in the incidence of nutritional risk between the two groups in the first to the third week of NRS2002 screening radiotherapy.The incidence of nutritional risk in the experimental group in the fourth to the seventh week was significantly lower than that in the control group,which was 15.2%vs 43.5%,30.4%vs 60.9%,47.8%vs 71.7%and 58.7%vs 80.4%respectively(P<0.05).The completion rate of synchronous chemotherapy in the experimental group was higher than that in the control group(92,9%vs 72.0%,P<0.05).There is no significant differences in recent efficacy of radiotherapy between the two groups.The QLQ-C30 after radiotherapy showed that the experimental group was superior to the control group in the dimensions of total quality of life,body function,emotional function,pain,burnout,and loss of appetite(P<0.05).Conclusions:The oral nutritional supplements in whole-course of radiotherapy for nasopharyngeal carcinoma can reduce weight loss?the incidence of severe malnutrition,delay the time of nutritional risk,alleviate the radioactive mucosal side effect,increase the compliance of synchronous chemotherapy,and improve the quality of life after radiotherapy.