Relationship between nutrition, psychology before radiotherapy and radiosensitivity in patients with nasopharyngeal carcinoma

LI Minjie; SUN Xudong; SHEN Yuefeng

doi:10.3969/j.issn.1009-0460.2018.12.012

Abstract：Objective To analyze the changes of nutrition and psychology before radiotherapy and their relationship with radio-sensitivity in patients with nasopharyngeal carcinoma.Methods One hundred and ninety-three patients with nasopharyngeal carcinoma receiving intensity modulated radiation therapy in our hospital were recruited in this study from June 2014 to March 2018.The nutritional risk screening 2002 (NRS2002) score, hospital anxiety and depression scale (HADS) score, nutrition index (NI), weight, body mass index, prealbumin, serum albumin, transferrin, hemoglobin, red blood count and total lymphocyte count were detected before, during and after radiotherapy.The univariate and multivariate Logistic regression analyses were used to analyze the factors that may influence the radiosensitivity.Results There were 57 (29.53％), 125 (64.77％) and 164 (84.97％) patients with NRS2002≥3, 108 (55.96％), 79 (40.93％) and 54 (27.98％) patients with HADS 0-7 before, during and after radiotherapy.Moreover, the NI of patients before, during and after radiotherapy were 5.15±1.16, 4.83±1.02 and 3.41±0.97.The incidences of poor nutritional status and anxiety and depression after radiotherapy were higher than those before and during radiotherapy, which had higher NI (P＜0.05). One hundred and thirty-five (69.95％) patients were evaluated as radiosensitive and 58 (30.05％) as radioinsensitive at 3months after radiotherapy.The univariate Logistic analysis showed that the clinical staging, radiation dose, NI before chemotherapy and HADS before or during chemotherapy had statistically significant influence on the radiosensitivity (P＜0.05). According to the result of the multivariate Logistic regression analysis, clinical staging, NI and HADS before chemotherapy were independent prognostic factors (P＜0.05). Conclusion Radiotherapy can cause the NI decrease and aggravate the degrees of anxiety and depression in nasopharyngeal carcinoma patients.Pre-radiotherapy NI in nasopharyngeal carcinoma patients is an important factor for prediction of radiosensitivity, and patients with NI＜5 and HADS＞7 are at the high risk for radiation insensitivity.