ABSTRACT
Objective This study aimedto evaluate the influence of nutritional status on the quality of life of a cohort of cancer patients submitted to chemotherapy. Methods Patients receiving chemotherapy for the first time in a University Hospital in Pelotas (RS), Brazil, were evaluated prospectively. Their nutritional risk was determined by the Patient-Generated Subjective Global Assessment scores and their quality of life by the World Health Organization's quality of life questionnaire, administered at the beginning and end of the study. Results One hundred and forty-three patients were studied, 76.2 percent being females. The prevalence of malnutrition at baseline was 14.0 percent. The present study found that malnourished patients had a poor quality of life. The nutritional risk of 41.6 percent of the patients increased after chemotherapy. A significant association was found between the presence of symptoms and increased nutritional risk (p<0.001). Additionally, there was a significant negative correlation between physical domain and nutritional risk scores, showing that quality of life increases as nutritional risk decreases. Conclusion Nutritional risk is inversely associated with quality of life in cancer patients after chemotherapy. Early nutritional interventions could minimize the side effects of treatment with a positive impact on quality of life.
Objetivo Avaliar a influência do estado nutricional sobre a qualidade de vida em uma coorte de pacientes submetidos à quimioterapia. Métodos Avaliaram-se prospectivamente pacientes em quimioterapia de um hospital universitário de Pelotas (RS), Brasil. O estado nutricional foi avaliado por meio dos escores obtidos pela Avaliação Subjetiva Global Produzida Pelo Paciente e a qualidade de vida foi avaliada a partir da versão abreviada do questionário de qualidade de vida da Organização Mundial da Saúde. A Avaliação Subjetiva Global Produzida Pelo Paciente e o questionário de qualidade de vida foram aplicados no início e no final do estudo. Resultados Foram avaliados 143 pacientes, dos quais 76,2 por cento eram mulheres. A prevalência de desnutrição na avaliação inicial foi de 14,0 por cento. Observou-se que, tanto no início quanto no final do estudo, os pacientes desnutridos apresentaram pior qualidade de vida. Houve aumento do risco nutricional em 41,6 por cento dos pacientes. Foi encontrada associação significativa entre a presença de sintomas e o aumento do risco nutricional (p<0,001). Além disso, houve correlação negativa estatisticamente significativa entre a variação dos escores do domínio físico e risco nutricional, evidenciando que conforme o risco nutricional diminui, melhora a qualidade de vida. Conclusão Conclui-se que as modificações no risco nutricional estão associadas a mudanças na qualidade de vida em pacientes com câncer. Sugere-se que o acompanhamento multidisciplinar desses pacientes poderia minimizar os efeitos colaterais do tratamento, diminuindo o risco de desnutrição, com repercussões positivas na qualidade de vida.
ABSTRACT
PURPOSE: Phase angle (PA), determined by bioelectrical impedance analysis (BIA), has been considered as a prognostic factor in several clinical conditions. The purpose of this study is to investigate PA, after adjusting for sex and age (standardized phase angle; SPA) as a prognostic factor for survival in cancer patients. METHODS: A prospective study was conducted in 195 patients before the first chemotherapy course. BIA was performed in all patients and SPA was calculated. The Kaplan-Meier method was used to calculate survival. The Cox regression method was used to evaluate the independent prognostic effect of PA after adjustment for other variables. RESULTS: Patients with SPA < -1.65 had a smaller survival rate than those with SPA ≥ -1.65 (p < 0.001). Using Cox regression, the mortality rate was higher in patients with SPA < -1.65 (RR 3.12 CI: 2.03-4.79; p < 0.001). After multivariate analysis, patients with PA < -1.65 still presented a higher mortality rate (RR 2.35 CI: 1.41-3.90; p = 0.001). CONCLUSIONS: The present study demonstrates that PA, used as SPA, is an independent prognostic indicator in this group of cancer patients receiving chemotherapy treatment even after adjustment for other prognostic variables.
