头颈部肿瘤患者放射治疗期间严重体重丢失变化轨迹
及影响因素分析

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摘要目的调查头颈部肿瘤患者放射治疗(简称放疗)期间严重体重丢失的变化趋势并分析其影响因素。方法采用回顾性队列研究设计,便利选择 2021 年 9 月至 2023 年 10 月在中南大学湘雅医院接受放疗的头颈部肿瘤患者作为研究对象。使用自行编制的资料收集工具在放疗前(T0 )、放疗开始后第 1 周(T1 )、第 2 周(T2 )、第 3 周(T3 )、第 4 周(T4 )、第 5 周(T5 )和第 6 周(T6 )收集研究对象的相关信息。使用广义估计方程分析严重体重丢失轨迹的影响因素。结果本研究共纳入 575 例头颈部肿瘤患者,严重体重丢失在 T1 、T2 、T3 、T4 、T5 和 T6 的发生率分别为 1. 22%、6. 43%、14. 61%、24. 87%、37. 39%和 52. 52%。广义估计方程分析结果显示,临床分期(以Ⅰ期作为参照,ORⅡ期 = 3. 685、ORⅢ期 = 3. 520、ORⅣ期 = 3. 792)、基线 BMI(以 BMI< 18. 5 kg / m 2 作为参照,OR24. 0~ 28. 0 kg / m 2 = 2. 832、OR≥28. 0 kg / m 2 = 3. 481)和白蛋白(OR = 0. 943)是头颈部肿瘤患者放疗期间严重体重丢失轨迹的影响因素(P<0. 05)。结论头颈部肿瘤患者严重体重丢失发生率随放疗周期延长呈上升趋势,医护人员应动态监测头颈部肿瘤患者放疗期间的体重变化,针对晚期、高 BMI 和低白蛋白患者,优先开展多层次的营养管理,以降低营养不良发生率。

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	1刘美子
	1高菲
	3吴子童
	2安然
	3陈文凤

关键词 ：头颈部肿瘤, 放射治疗, 体重丢失, 轨迹, 影响因素

Abstract：Objective To investigate the trend of critical weight loss during radiotherapy in head and neck cancer patients and to analyze its influencing factors. Method A historical cohort study design was used. Head and neck cancer patients treated with radiotherapy in Xiangya Hospital Central South University were enrolled for the research from September 2021 to October 2023. A self-developed data collection tool was used to collect information about the study subjects before radiotherapy T0 at week 1 T1 week 2 T2 week 3 T3 week 4 T4 week 5 T5 and week 6 T6 after the start of radiotherapy. Factors influencing the trajectory of critical weight loss were analyzed using generalized estimated equation. Result A total of 575 head and neck cancer patients were included in this study and the incidence of critical weight loss was 1. 22% 6. 43% 14. 61% 24. 87% 37. 39% and 52. 52% at T1 T2 T3 T4 T5 and T6 respectively. The generalized estimated equation analysis revealed that clinical stage with stageⅠ as reference ORⅡ = 3. 685、 ORⅢ = 3. 520、 ORⅣ = 3. 792 baseline BMI with BMI < 18. 5 kg / m 2 as reference OR24. 0~ 28. 0 kg / m 2 = 2. 832、OR≥28. 0 kg / m 2 = 3. 481 and albumin level OR = 0. 943 were significant predictors P< 0. 05 for critical weight loss trajectories during radiotherapy in head and neck cancer patients. Conclusion The incidence of critical weight loss in head and neck cancer patients is on the rise with the prolongation of radiotherapy cycles. Healthcare professionals should dynamically monitor weight changes in head and neck cancer patients during radiotherapy with prioritized implementation of multi - level nutritional interventions for patients with advanced-stage disease high BMI or low albumin levels to reduce the incidence of malnutrition.

Key words： Head and neck cancer Radiotherapy Weight loss Longitudinal trajectory Influencing factors

基金资助:湖南省自然科学基金(2025JJ70636)

通讯作者: 陈文凤,电子邮箱:wfc_xiangya@ csu. edu. cn

引用本文:

1刘美子,1高菲,3吴子童,2安然,3陈文凤. 头颈部肿瘤患者放射治疗期间严重体重丢失变化轨迹及影响因素分析[J]. 肿瘤代谢与营养电子杂志, 2025, 12(5): 616-624.
1Liu Meizi,1Gao Fei,3Wu Zitong,2An Ran,3Chen Wenfeng. Analysis of the trajectory of critical weight loss changes and influencing factors in head and neck cancer patients during radiotherapy. Electron J Metab Nutr Cancer, 2025, 12(5): 616-624.