| Aims : To investigate the effect of nutritional status on adjuvant chemotherapy tolerance and negative emotion of gastric cancer patients who underwent radical gastrectomy,aiming to provide a theoretical basis for the anticipatory nursing care of patients with such disease,and to enrich the connotation of the clinical nursing work.Methods:A total of 78 patients who underwent adjuvant chemotherapy after radical surgical treatment for gastric cancer in our institution from July 2015 to April 2017 were enrolled prospectively.According to the recommendations of the European Society for Parenteral Enteral Nutrition(ESPEN),using the body mass index(BMI)of18.5 kg/m2 as the cut-off value,the patients’ pre-chemotherapeutic nutritional status can be divided into mal-nutrition group(n = 40)and non-malnutrition group(n = 38).Pre-chemotherapeutic hematological nutritional parameters,including: pre-albumin,albumin,and transferrin,and hemoglobin,were compared between the two groups.All patients received combination chemotherapy containing fluoropyrimidines and taxanes as the adjuvant therapy,with every 3 weeks as one cycle and a maximum of six cycles of chemotherapy.Before and after each adjuvant chemotherapy treatment,routine blood tests and biochemical tests were performed to compare the occurrence of adverse reactions between the two groups of patients.The main outcome measures included anorexia,nausea and vomiting,abdominal distension and other adverse reactions of digestive system,as well as myelosuppression reactions such as leukopenia,thrombocytopenia and erythrocytopenia.The situation of how was the chemotherapygoing on as completion or discontinuation in the two groups was recorded,and the proportion of patients whose chemotherapy was early terminated due to serious adverse events was analyzed.In the meantime,the Positive and Negative Affect Scale(PANAS)was used to evaluate the negative emotion between the two groups,and the comparison of negative emotion between patients in the same group before and after chemotherapy was also assessed.Results : 1.There was no significant difference in general data(gender,age,BMI,hypertension,diabetes,TNM stage of tumor)before chemotherapy(P > 0.05).2.All patients completed at least two cycles of chemotherapy.60 of them completed the prescribed 6 cycles of chemotherapy,and 18 of them terminated chemotherapy in advance due to the serious adverse reactions of chemotherapy,including 13 cases in mal-nutrition group and 5 cases in non-malnutrition group.3.During chemotherapy,both groups of patients experienced different degrees of chemotherapy-related adverse reactions,including non-hematological toxicities(loss of appetite,nausea and vomiting,and abdominal distension,etc)and hematological toxicities(eg.leukopenia,thrombocytopenia and erythrocytopenia,etc).The proportion of both non-hematological toxicities and hematological toxicities in the mal-nutrition group was significantly higher than that in the non-malnutrition group(both P < 0.05).The proportion of chemotherapy discontinuation was significantly higher in the mal-nutrition group than in the non-malnutrition group [(32.5%,13/40)vs.(13.2%,5/38),P = 0.032].4.There was no statistically significant difference in the PANAS scores of the two groups before chemotherapy(P > 0.05).When the chemotherapy was terminated,the PANAS scores of patients in both groups were significantly higher than those before chemotherapy(P < 0.01),and the scores of patients in the mal-nutrition group were significantly higher than those in the non-malnutrition group(P < 0.01).Conclusion:In patients with gastric cancer undergoing adjuvant chemotherapy after radical gastrectomy,chemotherapy intolerance and negative emotions are more likely to be observed in patients with malnutrition than those with normal nutrition,thus affecting the smooth progress of adjuvant chemotherapy. |
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