The Effect Of Nutritional Support Based On Dietary Anti-inflammatory Index On Cancer-related Fatigue In Lung Cancer Patients Undergoing Chemotherapy

Background Lung cancer is the leading cause of cancer deaths in the world,and the prevalence and deaths of lung cancer are increasing year by year.Cancer-related fatigue（CRF）is a subjective feeling related to cancer or cancer treatment,which is out of proportion to recent activities and cannot be passed.Fatigue or exhaustion relieved by rest.At present,although dietary intervention is considered to be a key treatment strategy for CRF,the most appropriate dietary plan to reduce CRF has not yet been established.More and more evidences show that there is a close connection between the inflammatory state and the occurrence and development of CRF.The question is whether the observed inflammatory state can be modified by anti-inflammatory diet,and whether this modification can in turn improve CRF is unknown.of.Therefore,this study took patients with lung cancer chemotherapy as the research object,and explored nutritional support based on dietary anti-inflammatory index to reduce the level of cancer-related fatigue in patients with lung cancer chemotherapy to improve the quality of life.Objective To explore the effect of nutritional support based on dietary anti-inflammatory index on cancer-related fatigue in patients with lung cancer chemotherapy.Methods In this study,a randomized controlled trial was used to select 106 lung cancer patients with fatigue（BFI≥4 points）from December 2019 to December 2020 as the research subjects,and computer-generated random number method was used to randomly assign patients to the anti-inflammatory diet group（n=53）or the usual diet group（n=53）for a 3-month dietary intervention..The main measurement is cancer-related fatigue,and the secondary measurement indicators include quality of life,anxiety and depression,and patient self-evaluation subjective comprehensive assessment Scale,hs-CRP and nutritional status.This study uses repeated measures analysis of variance to perform statistical analysis on longitudinal data,observe the changes of measurement indicators at four time points（T0,T1,T2,T3）,and use patient compliance and completion rate and the incidence of adverse events to evaluate effectiveness of dietary intervention programs.Results There was no statistically significant difference between the AI-diet group and the Usual diet group in terms of general sociodemographic and clinical data（P>0.05）,indicating that the two groups of patients have a good balance and comparability;3 months of AI-diet intervention improved the fatigue score of cancer patients（T3:P<0.01）,repeated measures analysis of variance showed that the two groups had a significant time trend(F=45.573,P_time=0.01)and the difference between the two groups was statistically significant（F=3.803,P=0.05）;the anti-inflammatory diet also changed the hs-CRP levels of the two groups（P=0.01）.Repeated measurement analysis of variance showed that the two groups had a significant time trend(F=8.867,P_time=0.01),but the difference between the two groups was not significant(F=0.001,P_groups=0.97);The stratified analysis of hs-CRP at baseline showed that when hs-CRP<10 mg/L,the difference in hs-CRP levels between the two groups at T3 was statistically significant（P<0.01）,and repeated measures analysis of variance showed that the two groups had a clear trend of time change(F=2.778,P_time=0.05),and the two groups had more significant differences(F=5.089,P_groups=0.03);The Usual diet group and AI-diet group had statistical differences in total protein（T3:P=0.01,T2:P=0.02）,depression score（T3:P=0.02）and PG-SGA score（T3:P=0.03）;in terms of patient quality of life,the emotional function score of the two groups of patients（T2:P=0.04,T3:P=0.02）,constipation symptom score（T2:P=0.02,T3:P=0.01）,the difference in cognitive function score（T3:P=0.02）and sleep disorder score（T3:P=0.02）were statistically significant.The AI-diet group showed a high degree of compliance and completion rate of the anti-inflammatory diet intervention.The proportion of people who followed the anti-inflammatory diet at T2 was 98%（n=52/53）and reached 96%at T3（n=51/53）,no intervention-related adverse events occurred during the entire intervention period.Conclusion In this study,AI-diet intervention combining cancer-induced fatigue,inflammation and diet intervention was used to explore the effects of dietary anti-inflammatory index-based nutritional support on cancer-related fatigue,inflammatory markers,quality of life,anxiety and nutritional status in lung cancer undergoing chemotherapy.It was found that anti-inflammatory diet is more effective than usual diet in improving CRF of lung cancer patients undergoing chemotherapy.The anti-inflammatory diet regimen may be an important non-drug treatment,and it also opens up new ways for the systematic dietary intervention of cancer-related fatigue.