Investigation and analysis of malnutrition after adjuvant chemotherapy in patients with gastrointestinal tumor / 肠外与肠内营养

ABSTRACT

Objective:This study aims to investigate the incidence and potential cause of the undernutrition in gastrointestinal cancer patients received postoperatively adjuvant chemotherapy.Method:Between July and December 2016,a total of 181 gastrointestinal cancer patients who underwent postoperatively adjuvant chemotherapy in the Department of General Surgery of Nanjing General Hospital were enrolled in this study.Nutritional risks of the patients were screened by the patient-generated subjective global assessment (PG-SGA).Serum albumin concentrations,plasma hemoglobin levels and white blood cell numbers of the patients were determined during the chemotherapy.The patients'clinical data,including gender,age,tumor location,chemotherapy stage and adverse events post the chemotherapy,were recorded.Result:All patients completed the PG-SGA for nutritional risk screening.Among the patients,69 cases (38.1％) had a PG-SGA score of 0 ～ 3 points,showing absence of undernutrition.The remaining 112 cases (61.9％)had a PG-SGA score above 4 points,indicating moderate or severe undernutrition.71cases (39.2％) of them displayed moderate underuutrition (4-8 points),and 41 cases (22.7 ％) showing severe undernutrition (＞ 8 points).The PG-SGA scores in patients with gastric cancer were significantly higher than those in the rectal cancer patients (P ＜ 0.05) and in the colon cancer cases (P ＜ 0.01).In addition,the incidence of undernutrition in the male patients was much higher than in the female cases (P ＜ 0.05).The incidence of undernutrition in the patients aging ＞ 65 years was higher than in the cases below 65 years old (P ＜ 0.05).The levels of plasma hemoglobin and numbers of white blood cells were significantly lower in the patients with undernutrition (PG-SGA score ＞4 points),and adverse events such as nausea and vomiting were also more frequently presented in these cases.No significant difference in the incidence of the patients' undernutrition was observed between different stages of the chemotherapy.Conclusion:The patients with gastrointestinal cancer underwent postoperatively adjuvant chemotherapy had higher incidence ofundernutrition.Gender,age and tumor location were the risk factors for the development of undernutrition.Our findings provide evidence for the utilization of nutrition interventions in these patients.