摘要目的:分析探讨头颈部恶性肿瘤(head and neck cancer, HNC)患者放射治疗(放疗)结束时的营养不良状况与营养相关症状和生活质量的关系。方法:通过便利抽样法选择2018年12月至2020年1月于北京某肿瘤医院放疗科门诊头颈组完成放疗的HNC患者为横断面研究对象。采用以下3种标准进行营养不良评定：体重指数(body mass index, BMI)<18.5 kg/m 2伴一般情况差(简称BMI标准)；营养风险筛查2002评分(nutritional risking screening 2002，NRS 2002)营养状态受损评分为3分(简称NRS 2002标准)；全球(营养)领导人诊断营养不良标准(global leadership initiative on malnutrition，GLIM)但不包括肌肉量测定(简称GLIM标准)，并根据GLIM标准将患者分为营养不良与营养正常两组。采用头颈部患者症状调查表调查营养相关症状情况。采用欧洲癌症研究与治疗组织生活质量核心评定量表调查生活质量。 结果:共210例HNC患者纳入分析，根据BMI标准，19例(9.0%)患者存在营养不良；根据NRS 2002标准，110例(52.4%)患者存在营养不良；根据GLIM标准，145例(69.0%)患者存在营养不良。发生率>80.0%的营养相关症状有疼痛、口干、唾液黏稠和味觉改变，对进食干扰程度>3分的营养相关症状有疼痛、吞咽困难、口腔溃疡、味觉改变和食欲不振；总体健康状况得分为(51.47±21.48)分。营养不良患者与营养正常患者相比，营养相关症状频率总分更高(40.09±9.23)分比(33.63±9.13)分， P<0.01；对进食干扰程度总分更高(30.97±6.53)分比(25.85±6.54)分， P<0.01；而总体健康状况得分则更低(48.10±20.59)分比(58.97±21.67)分， P＝0.001。 结论:HNC患者放疗结束时营养不良发生率高，营养相关症状普遍且对进食影响大，营养不良患者的营养相关症状更多、更重，生活质量更差，提示医护人员应持续关注放疗结束后HNC患者的营养状况和营养相关症状情况，进行营养干预及症状管理，以改善其生活质量。

abstractsObjective:To characterize the malnutrition status, nutrition impact symptoms and quality of life at the end of radiotherapy in patients with head and neck cancer (HNC) and explore the association between nutritional status with nutrition impact symptoms and quality of life.Methods:This was a cross-sectional study. HNC patients who completed radiotherapy in the head and neck radiotherapy department of a cancer hospital in Beijing from December 2018 to January 2020 were recruited through convenient sampling. Three criteria were used to assess malnutrition: (1)BMI < 18.5 kg/m 2 with poor general condition; (2) scored 3 for impaired nutritional status in nutrition risk screening 2002 (NRS 2002); (3) assessed as malnutrition using the global leadership initiative on malnutrition (GLIM) criteria (muscle mass measurement not included). According to GLIM criteria, patients were divided into two groups of malnutrition and normal nutrition. The head and neck patient symptom checklist (HNSC) was used to assess the nutrition impact symptoms and the European organization for research and treatment of cancer quality of life core questionnaire (EORTC QLQ-C30) was used to assess the quality of life. Results:A total of 210 HNC patients were included in the final analysis. Malnutrition was present in 19 (9.0%), 110 (52.4%) and 145 (69.0%) patients according to the standard of BMI, impaired nutritional status of NRS-2002 and GLIM criteria, respectively. Nutrition impact symptoms present in more than 80.0% of patients included pain, xerostomia, saliva viscid, and taste alteration, and nutrition impact symptoms interfering food intake for > 3 points were pain, dysphagia, mouth ulceration, taste alteration, and loss of appetite. The global health score of the patient was 51.47±21.48. Compared with patients with normal nutrition, patients with malnutrition had higher scores for NIS frequency (40.09±9.23 vs 33.63±9.13, P<0.01) and the interference with food intake (30.97±6.53 vs 25.85±6.54, P<0.01), and lower global health scores (48.10±20.59 vs 58.97±21.67, P=0.001). Conclusions:At the end of radiotherapy, HNC patients had a high incidence of malnutrition. Nutrition impact symptoms were generally present and had a great influence on food intake. Patients with malnutrition experienced more and worse nutrition impact symptoms and worse quality of life. It is suggested that medical staff should continue to pay attention to the nutritional status and nutrition impact symptoms of HNC patients after radiotherapy and carry out nutritional intervention and symptom management to improve their quality of life.