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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
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。
並列摘要
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.
延伸閱讀
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- 林佩蓉（2017）。頭頸癌病人放射治療品質影響因素之研究〔碩士論文，義守大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0074-1008201712023600
- 柯淑貞（2014）。介入口服營養補充品對頭頸癌放射線治療病人營養狀況之影響〔碩士論文，中山醫學大學〕。華藝線上圖書館。https://doi.org/10.6834/CSMU.2014.00064
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