The Nutritional Status of Oncological Patient Prior to Antitumor Treatment: Single-Center Prospective Observational Study

Clinical nutrition and metabolism(2021)

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摘要
Background: Malnutrition is a frequent medical problem of cancer patients (pts) that negatively impacts of results of antitumor treatment. Aim: To study the problem of malnutrition in cancer hospital. Materials and methods: The observational study included 80 pts (30 males, age 51.6±13.6 years) who underwent examination before antitumor treatment (medical/surgical). Body mass index (BMI), weight loss (WL) over last 6 months, decrease in appetite before admission, reasons for decrease in food intake, physical activity, nosology, cancer staging, the time to diagnosis, therapy status, total protein (TP), albumin, absolute lymphocyte count (ALC) were evaluated. The data were analyzed by SPSS13.0 software. The results were expressed as mean ±SD. Results: The BMI was 25.3±5.4 kg/m 2 , WL 9.0±0.1%. The most common pathology were esophageal/gastric cancer (31%), stage IV (77%). 25% had received treatment within the last 6–12 months, 60% of the pts had received chemotherapy, of whom 36% had received 1st-line chemotherapy. Only 13% had additionally used enteral nutrition. An unwanted reduction of appetite was observed in 75% of pts. Most of them (34%) could not explain the reason of WL, 31% reported nausea/vomiting, 19% referred to anorexia; 13% showed consequences of chemotherapy toxicity (dysgeusia, stomatitis), 3% could not eat properly due to the pain syndrome. Of 60 patients who lost weight unintentionally, 54 (67.5%) had an average WL 14.1±9.1%. WL up to 5% was in 5 pts (6.25%), up to 10% in 14 pts (17.5%) and in 35 pts (43.75%) — more than 10%. 46% retained their usual daily activity, 80% deemed it useful to include a nutritional program in the treatment. The concentration of TP was 63.5±8.1 g/l, albumin 34.9±7.4 g/l, ALC 1.6±0.6×10 9 /l. Conclusions: Cancer patients have direct prerequisites for the development of cachexia, and, according to our study, 6.25% of patients were at the stage of precachexia, and 61.25% already had cachexia at the time of inclusion in the study. Although their compensatory capacity is quite high, the appointment of additional nutritional support is an integral component of the management of these patients. However, according to our data, only one tenth of patients used some kind of nutritional support. Nevertheless, in case of antitumor treatment, nutritional status evaluation must be mandatory in order to address the issue of nutritional support.
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关键词
Nutritional Status,Nutrition Support Therapy,Cancer in Older Adults,Malnutrition
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