Symptoms and weight loss in patients with gastrointestinal and lung cancer at presentation
Symptoms and weight loss in patients with gastrointestinal and lung cancer at presentation
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DOI：
10.1007/s00520-006-0091-0
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发表时间：
2007-01-01
影响因子：
3.1
通讯作者：
Andreyev, H. J. N.
中科院分区：
文献类型：
--
作者：
Khalid, U.;Spiro, A.;Andreyev, H. J. N.
引言：体重减轻是癌症患者生存率降低的独立预后因素。治疗的有效性在体重减轻的患者中受损。这种体重减轻的病因是复杂的，特征不明确。减少卡路里摄入可能很重要。摄入量减少的原因尚不清楚。目的和方法：确定尚未开始化疗或放疗的成年癌症患者中，对营养状况有风险的症状的患病率，以及这些症状与体重减轻、肿瘤负荷和原发肿瘤部位的关系。转诊接受任何形式的胃肠道（GI）癌、非小细胞肺癌或肺间皮瘤治疗的新患者完成了一项经验证的问卷调查，记录了导致体重减轻的症状（患者生成的主观总体评估-PG-SGA）。在没有转移性疾病的患者亚组中，评估计算机断层扫描以确定肿瘤负荷。结果：2004年8月至10月，122例胃肠道和29例肺癌患者被招募。48%的胃肠道患者和28%的肺癌患者体重减轻。62%的患者有一个或多个症状。症状的频率根据疾病的部位而变化。所有肿瘤部位最常见的症状是食欲不振（38%）。有一个弱，但显着的相关性之间的症状和体重减轻量（r=0.347）。报告食物摄入量减少的患者比体重没有减轻的患者有更多的症状。肿瘤负荷与体重减轻无关。结论：癌症患者的症状发生在不同类型的原发性肿瘤中，可能会影响食物摄入，并导致体重减轻。需要更多关于症状管理在改善营养状况方面的作用的信息。
Introduction: Weight loss is an independent prognostic factor for decreased survival in cancer patients. The effectiveness of treatment is impaired in patients with weight loss. The aetiology of this weight loss is complex and poorly characterised. Decreased calorie intake may be important. The reasons for decreased intake are unknown. Aims and methods: To determine in adult patients with cancer, who had not started chemotherapy or radiotherapy, the prevalence of symptoms which carry a risk to nutritional status and how these relate to weight loss, tumour burden and primary tumour site. New patients referred for treatment of any form of gastrointestinal (GI) cancer, non-small cell lung cancer or lung mesothelioma completed a validated questionnaire recording symptoms contributing to weight loss (Patient-generated Subjective Global Assessment-PG-SGA). In a subset of patients without metastatic disease, computed tomography scans were assessed to determine tumour burden. Results: Between August and October 2004, 122 patients with GI and 29 with lung cancers were recruited. There were 48% of GI and 28% of lung cancer patients who had lost weight. Sixty-two percent of the patients had one or more symptoms at presentation. The frequency of symptoms varied according to the site of disease. The most common symptom at all tumour sites was loss of appetite (38%). There was a weak but significant correlation between the number of symptoms and amount of weight loss (r=0.347). Patients reporting a reduced food intake had more symptoms than patients who had not lost weight. Tumour burden did not correlate with weight loss. Conclusion: The symptoms in cancer patients occur across different types of primary tumours, may affect food intake and have a part in causing weight loss. More information on the role of symptom management in improving nutritional status is needed.