Výsledek screeningu nutričního rizika u pacientů s karcinomem plic predikuje odpověď nádoru na léčbu
| Title in English | Results of nutritional risk screening in patients with lung cancer predict tumor response to therapy |
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| Authors | |
| Year of publication | 2013 |
| Type | Article in Periodical |
| Magazine / Source | Studia pneumologica et phthiseologica |
| MU Faculty or unit | |
| Citation | |
| Field | Pneumology |
| Keywords | lung cancer; NRS; tolerance of treatment; treatment response |
| Description | Background: Malnutrition in cancer patients may be associated with poor tolerance of chemotherapy and lower response rate after oncological treatment. Methods: Nutritional Risk Screening (NRS) 2002 adapted for oncological patients was used to assess the risk of undernutrition in a group of 188 lung cancer patients. The risk was evaluated on a 6-point scale according to common signs of nutritional status and tumor and its treatment risk factors. A score of 3 and more (called "nutritional risk") means a significant risk of malnutrition and poor treatment outcome. Results: There were 133 (70.7 %) men and 55 (29.3 %) women with a mean age of 64.9 years. Tumor stages from I to IV were classified in 10.6 % (I), 4.3 % (II), 9.6 % (IIIA), 25.0 % (IIIB) and 48.6 % (IV] patients. Non-small cell lung cancer was diagnosed in 66.0 % and small cell lung cancer in 27.7 % of patients. Acceptable NRS score of 0-2 points was found in 50.6 %, while in 45.3 % the 3-5 score suggested the risk of malnutrition ("nutritional risk"). Unexpectedly, the toxicity of anticancer treatment was not significantly different between the subgroups ("acceptable score" vs. "nutritional risk") with a mean toxicity on the 0-4 point scale of 1.6 (SD 1-3; 95% CI 1.3-2.0) in patients with higher NRS scores as compared to 1.2 (SD 1.2; 95% CI 1.0-1.5) in the lower NRS score group (p = 0.061). The rate of treatment response (RR) evaluated by imaging techniques was significantly higher in patients with the "acceptable score" (1-2 points) compared to those with a "nutritional risk" (3-5 points) (57 % vs. 30 %; p = 0.001). The overall survival rate was significantly higher in lung cancer patients treated with cytostatics and the "acceptable score" as compared to patients at a "nutritional risk" (13.5 months vs. 7.9 months; p = 0.001). Conclusion: Nutritional risk screening is a significant predictor of tumor response in lung cancer patients. Early detection of malnutrition is important to determine the prognosis of cancer patients as well as to plan effective supportive care. |