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題名 | 簡易營養評估對頭頸癌病人預後之影響=Assessment of the Survival Rate of Patients with Head and Neck Cancer Using the Mini Nutritional Assessment--Taiwan Version |
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作者 | 黃培寧; 李靜慧; 許維中; 賴淑娥; | 書刊名 | 臺灣營養學會雜誌 |
卷期 | 44:1 2020.03[民109.03] |
頁次 | 頁26-32 |
分類號 | 411.3 |
關鍵詞 | 頭頸癌; 簡易營養評估; 存活率; Head and neck cancer; HNC; Mini nutritional assessment; MNA; Survival rate; |
語文 | 中文(Chinese) |
中文摘要 | 目的:利用簡易營養評估(MNA)台灣修訂版評估頭頸癌病人存活率。材料與方法:自2011年1月至2016年12月,以中部某教學醫院頭頸癌病人共64位為研究對象。納入標準包括:(1)年滿18歲;(2)經病理學診斷為頭頸癌;(3)治療前接受過營養師MNA評估。根據MNA總分區分為營養良好組(MNA ≥ 24; n = 36)與營養不良風險組(MNA < 24; n = 28),並以傾向分數配對法(propensity score matching)進行分析。結果:約有半數頭頸癌病人(43%)為營養不良風險組,其白血球濃度、熱量攝取量以及熱量達標率顯著低於營養良好組。營養良好組與營養不良風險組的一年存活率分別為77.0%與68.4%,三年存活率分別為38.5%與15.8%,而診斷時MNA評估營養狀況會顯著影響存活率(p = 0.043)。結論:頭頸癌病人營養不良是相當普遍的。以MNA評估為營養不良風險組的頭頸癌病人有較低的白血球濃度與存活率。因此,MNA評估可作為早期偵測營養不良的營養評估工具,營養師可借由營養評估資料,針對頭頸癌病人提供營養介入,以利於改善頭頸癌病人預後。 |
英文摘要 | Purpose: To evaluate the impact of the Mini-Nutritional Assessment (MNA)on the survival rate of patients with head and neck cancer (HNC). Materials and Methods: Between January 2011 and December 2016, 64 patients with HNC treated at a teaching hospital in central Taiwan were enrolled in this study. The inclusion criteria included:(1) aged over 18 years old;(2) HNC revealed by pathology; and (3) having received an MNA evaluation at diagnosis by a dietitian. According to MNA values, we divided patients into a well-nourished group (MNA ≥ 24; n = 36) and a nutritional-risk group (MNA < 24; n = 28). Propensity score matching (PSM) was used to analyze the data. Results: Around half (43%) of patients with HNC were malnourished or at risk of malnutrition. The nutritional-risk group had significant lower values of white blood cell concentration than the well-nourished group. In addition, the nutrition status at diagnosis also impacted survival rates (p = 0.043). The 1-year survival rates for the well-nourished group and nutritional-risk group were 77.0% and 68.4%, respectively; while 3-year survival rates were 38.5% and 15.8%, respectively. Conclusions: Malnutrition is a common phenomena in patients with HNC. A low white blood cell concentration and a poor survival rate were found in the nutritional-risk group. Thus, early detection of malnutrition would enable preventive strategies and in-time interventions for patients with HNC in order to improve their prognosis. |
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