Abstract Objective To apply Nutritional Risk Screening-2002(NRS-2002) to perform primary screening for nutritional risk in patients with esophageal cancer who undergo radiotherapy, and assess their nutritional status, and to investigate the value of NRS-2002 in such patients. Methods A total of 97 patients who were diagnosed with esophageal cancer and underwent radiotherapy in Zhejiang Cancer Hospital from January 2010 to April 2014 were analyzed retrospectively. The Kaplan-Meier method was applied to analyze the difference in survival, and the chi-square test and the Pearson correlation analysis were applied to analyze the correlation between NRS-2002 score and blood parameters. Results Of all patients, 26.8% had nutritional risk before radiotherapy, which gradually increased with the progress of radiotherapy. The 1-year overall survival rates of the patients with NRS-2002 scores of ≤3 and ≥4 on admission were 91.1% and 61.9%, respectively (P=0.010). As for the patients with the highest NRS-2002 scores of ≤2 and ≥3 during treatment, the 1-year overall survival rates were 94.2% and 77.5%, respectively (P=0.012). As for the patients with the lowest NRS-2002 scores of ≤3 and ≥4 during treatment, the 1-year overall survival rates were 91.3% and 54.5%, respectively (P=0.018). The NRS-2002 score was correlated with prealbumin on admission and at week 1 of radiotherapy (P=0.000 and 0.002), and the NRS-2002 score was correlated with albumin at week 3 of radiotherapy (P=0.036). The multivariate analysis showed that the TNM stage of esophageal cancer and the highest NRS-2002 score during treatment were the independent prognostic factors in esophageal cancer (P=0.001 and 0.005). Conclusions The patients with esophageal cancer undergoing radiotherapy have high nutritional risk, and NRS-2002 score is the independent prognostic factor in these patients and can be used as a tool for primary screening for nutritional risk.
. Value of nutritional risk screening-2002 in evaluating nutritional status of patients with esophageal cancer undergoing radiotherapy[J]. Chinese Journal of Radiation Oncology, 2016, 25(3): 234-237.
. Value of nutritional risk screening-2002 in evaluating nutritional status of patients with esophageal cancer undergoing radiotherapy[J]. Chinese Journal of Radiation Oncology, 2016, 25(3): 234-237.
[1] Jemal A,Bray F,Center MM,et al. Global cancer statistics[J].CA Cancer J Clin,2011,61(2):69-90.DOI:10.3322/caac.20107. [2] Dechaphunkul T,Martin L,Alberda C,et al. Malnutrition assessment in patients with cancers of the head and neck:a call to action and consensus[J].Crit Rev Oncol/Hematol,2013,88(2):459-476.DOI:10.1016/j.critrevonc.2013.06.003. [3] Jager-Wittenaar H,Dijkstra PU,Vissink A,et al. Changes in nutritional status and dietary intake during and after head and neck cancer treatment[J].Head Neck,2011,33(6):863-870.DOI:10.1002/hed.21546. [4] Soeters PB,Reijven PLM,van Bokhorst-de van der Schueren MAE,et al. A rational approach to nutritional assessment[J].Clin Nutr,2008,27(5):706-716.DOI:10.1016/j.clnu.2008.07.009. [5] Fearon K,Strasser F,Danker SD,et al. Definition and classification of cancer cachexia:an international consensus[J].Lancet Oncol,2011,12(5):489-495.DOI:10.1016/S1470-2045(10)70218-7. [6] Odelli C,Burgess D,Bateman L,et al. Nutrition support improves patient outcomes,treatment tolerance and admission characteristics in oesophageal cancer[J].Clin Oncol,2005,17(8):639-645.DOI:10.1016/j.clon.2005.03.015. [7] Jeremic B,Shibamoto Y,Milicic B,et al. Impact of treatment interruptions due to toxicity on outcome of patients with early stage (Ⅰ/Ⅱ) non-small-cell lung cancer (NSCLC) treated with hyperfractionated radiation therapy alone[J].Lung Cancer,2003,40(3):317-323.DOI:10.1016/S0169-5002(03)00078-3. [8] Kondrup J,Hjgaard-Rasmussen H,Hamberg O,et al. Nutritional risk screening (NRS-2002):a new method based on an analysis of controlled clinical trials[J/OL].Clin Nutr,2003,22(3):321-336.DOI:10.1016/S0261-5614(02)00214-5. [9] Hu M,Ampil F,Clark C,et al. Comorbid predictors of poor response to chemoradiotherapy for laryngeal squamous cell carcinoma[J].Laryngoscope,2012,122(3):565-571.DOI:10.1002/lary.22489. [10] Fiore FD,Lecleire S,Pop D,et al. Baseline nutritional status is predictive of response to treatment and survival in patients treated by definitive chemoradiotherapy for a locally advanced esophageal[J].Am J Gastroenterol,2007,102(11):2557-2563.DOI:10.1111/j.1572-0241.2007.01437.x. [11] Shen LJ,Chen C,Li BF,et al. High weight loss during radiation treatment changes the prognosis in under-/normal weight nasopharyngeal carcinoma patients for the worse:a retrospective analysis of 2433 Cases[J].PLoS One,2013,8(7):e68660.DOI:10.1371/journal.pone.0068660. [12] Pai PC,Chuang CC,Tseng CK,et al. Impact of pretreatment body mass index on patients with head-and-neck cancer treated with radiation[J].Int J Radiat Oncol Biol Phys,2012,83(1):e93-e100.DOI:10.1016/j.ijrobp.2011.11.071. [13] Poulsen GM,Pedersen LL,sterlind K,et al. Randomized trial of the effects of individual nutritional counseling in cancer patients[J].Clin Nutr,2014,33(5):749-753.DOI:10.1016/j.clnu.2013.10.019. [14] Ravasco P,Monteiro-Grillo I,Marques-Vidal P,et al. Dietary counseling improves patient outcomes:a prospective,randomized,controlled trial in colorectal cancer patients undergoing radiotherapy[J].J Clin Oncol,2005,23(7):1431-1438.DOI:10.1200/JCO.2005.02.054. [15] Read JA,Crockett N,Volker DH,et al. Nutritional assessment in cancer:comparing the Mini Nutritional Assessment (MNA) with the scored Patient-Generated Subjective Global Assessment (PGSGA)[J].Nutr Cancer,2005,53(1):51-56.DOI:10.1207/s15327914nc5301_6. [16] Bauer J,Capra S.Comparison of a malnutrition screening tool with subjective global assessment in hospitalised patients with cancer-sensitivity and specificity[J].Asia Pac J Clin Nutr,2003,12(3):257-260. [17] Jeejeebhoy KN.Nutritional assessment[J].Nutrition,2000,16(7-8):585-590.DOI:10.1016/S0899-9007(00)00243-4. [18] Mokori A,Kabehenda MK,Nabiryo C,et al. Reliability of scored patient generated subjective global assessment for nutritional status among HIV infected adults in TASO,Kampala[J].Afr Health Sci,2011,11(S1):S86-S92.DOI:10.4314/ahs.v11i3.70076. [19] Wang BS,Yan X,Cai JJ,et al. Nutritional assessment with different tools in leukemia patients after hematopoietic stem cell transplantation[J].Chin J Cancer Res,2013,25(6):762-769.DOI:10.3978/j.issn.1000-9604.2013.12.09. [20] Liu P,Yan X,Wang BS,et al. Three methods assess nutritional status of leukemia patients before hematopoietic stem cell transplantation[J].Chin Med J (Engl),2012,125(3):440-443.DOI:10.3760/cma.j.issn.0366-6999.2012.03.007. [21] Unal D,Orhan O,Eroglu C,et al. Prealbumin is a more sensitive marker than albumin to assess the nutritional status in patients undergoing radiotherapy for head and neck cancer[J].Contemp Oncol,2013,17(3):276-280.DOI:10.5114/wo.2013.35281. [22] Orell-Kotikangas H,sterlund P,Saarilahti K,et al. NRS-2002 for pre-treatment nutritional risk screening and nutritional status assessment in head and neck cancer patients[J].Support Care Cancer,2014,23(6):1495-1502.DOI:10.1007/s00520-014-2500-0. [23] Suh YG,Lee IJ,Koom WS,et al. High-dose versus standard-dose radiotherapy with concurrent chemotherapy in stages Ⅱ-Ⅲ esophageal cancer[J].Jpn J Clin Oncol,2014,44(6):534-540.DOI:10.1093/jjco/hyu047. [24] Guerra LT,Rosa AR,Romani RF,et al. Serum transferrin and serum prealbumin as markers of response to nutritional support in patients with esophageal cancer[J].Nutr Hosp,2009,24(2):241-242.