Symptoms in advanced pancreatic cancer are of importance for energy intake
Symptoms in advanced pancreatic cancer are of importance for energy intake
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DOI：
10.1007/s00520-012-1514-8
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发表时间：
2013-01-01
影响因子：
3.1
通讯作者：
Hjermstad, Marianne Jensen
中科院分区：
文献类型：
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作者：
Bye, Asta;Jordhoy, Marit S.;Hjermstad, Marianne Jensen
癌症恶病质和低能量摄入（EI）可能有助于晚期胰腺癌（PC）的体重减轻。然而，对这种疾病的实际EI知之甚少。目的是评估EI，体重减轻和疾病过程中的症状，并调查症状和EI之间的关联。连续纳入39例晚期PC患者（21例男性），每4周随访一次，直到生命结束。24小时饮食回忆被用来评估EI。采用埃德蒙顿症状评估系统（ESAS）和PC特异性健康相关生活质量问卷（QLQ-PAN 26）进行症状评估，中位年龄为62岁（48-88岁），WHO体力状态评分为1（0-2），生存期为5个月（1-25）。17名（44%）患者患有不可切除的癌症，16名（41%）患者患有转移性癌症，6名（15%）患者患有复发性癌症。入选后，37例（95%）报告体重减轻（中位数4.0 kg/月）。在随访期间，每月平均体重减轻< 1.0 kg。在观察期间，40%至65%的患者EI < 29 kcal/kg/d（维持体重的截止值），但他们的体重并没有比EI <29 kcal的患者减轻更多。EI与疼痛（0.51-0.61）、疲劳（0.54-0.67）、口干（0.61-0.64）和食欲不振（0.53-0.71）呈显著负相关（r范围）。低EI不能完全解释该患者组的体重减轻，但仔细监测和早期随访症状可能是减少晚期PC体重减轻的重要干预措施。
Cancer cachexia and low energy intake (EI) probably contribute to weight loss in advanced pancreatic cancer (PC). However, little is known about the actual EI in this disease. Aims were to assess EI, weight loss and symptoms during the disease course and investigate associations between symptoms and EI.Thirty-nine patients (21 males) with advanced PC were consecutively included and followed every 4 weeks until the end of life. A 24-h dietary recall was used to assess EI. The Edmonton Symptom Assessment System (ESAS) and the PC-specific health-related quality of life questionnaire (QLQ-PAN26) were used for symptom assessment.Median age was 62 years (48-88), WHO performance status 1 (0-2) and survival 5 months (1-25). Seventeen (44 %) patients had unresectable cancer, 16 (41 %) metastatic and six (15 %) recurrent disease. Upon inclusion, 37 (95 %) reported weight loss (median 4.0 kg per month). During follow-up, median weight loss per month was < 1.0 kg. Forty to 65 % had EI < 29 kcal/kg/day (cut-off value for weight maintenance) during the observation period but they did not lose more weight than patients with EI a parts per thousand yenaEuro parts per thousand 29 kcal. Strong negative correlations (r range) were found between EI and pain (0.51-0.61), fatigue (0.54-0.67), oral dryness (0.61-0.64) and loss of appetite (0.53-0.71).In this study, several symptoms influenced EI negatively. Low EI did not completely explain weight loss in this patient group, but careful monitoring and early follow-up of symptoms may be important interventions to reduce weight loss in advanced PC.