| Objective To evaluate the effect of parenteral nutrition (PN) on the quality of life in elderly patients with non-small cell lung cancer (NSCLC) .Through prospective clinical research which supplying the elderly NSCLC patients with 9-aminofusin(9-AF) to support treatment during chemotherapy period, and to evaluate the nutritional status of the patients during the chemotherapy for founding out the theory evidence in reasonably supplying elderly NSCLC patients with PN for support treatment.Methods Seventy-eight elderly NSCLC patients, diagnosed with pathology were randomly assigned to parenteral nutrition group (40 cases) and control group (38 cases). Both two groups were NP (cis-dichlorodiamineplatinum+vinorelbine) chemotherapy project. Parenteral nutrition group were treated with chemotherapy plus 9-AF(500 ml/d ) at 10hr on evening for 8 days during chemotherapy period, Control group was merely supplied with chemotherapy treatment, continuously applied three periodicity. Separately before each chemotherapy period and after the third chemotherapy period, QLQ-C30 and QLQ-LC13 of European Organization for Research and Treatment of Cancer (EORTC) were used to examine QOL status before and after the chemotherapy. Body mass index (BMI), albumin (ALB), serum prealbumin (PAB), serum transferrin and lymphocyte count (LC) of patients of both two groups were measured to evaluate the nutritional status of each group patients before and after the chemotherapy. Results①Our data show that the score of physical function is increased after chemotherapy (P<0.05).The score of physical function in parenteral nutrition group is 65.65±14.34 and 89.36±7.24 respectively while in control group is 68.24±11.53 and 80.54±10.66 respectively.There are obvious differences of physical function in parenteral nutrition group than in control group (P<0.05). In parenteral nutrition group, there are significant differences both in emotional function and social function of patients after the chemotherapy (P<0.05) while there is no difference in control group. The score of emotional function in parenteral nutrition group before and after the chemotherapy respectively is 61.52±9.67 and 88.43±15.26, and that in control group respectively is 65.41±11.38 and 70.16±10.24, and both of the two groups the differences of emotional function before and after the chemotherapy had statistical significance(P<0.05),the score of social function in parenteral nutrition group before and after the chemotherapy respectively is 66.21±7.24 and 86.51±14.37, and that in control group respectively is 69.14±9.83 and 77.16±11.62, and both of the two groups the differences of social function before and after the chemotherapy had statistical significance(P<0.05); after the chemotherapy the score of role function in both two groups were lower than before(P<0.05),but there did not have statistical significance in parenteral nutrition group and control group after the chemotherapy; there did not have change in cognition function both in parenteral nutrition group and control group before and after the chemotherapy. Our data also show that both two groups had an obvious increase in general health(P<0.05)and aggravation in financial straits(P<0.05)after chemotherapy, but there is no significant difference of them after the whole period of chemotherapy in two groups. The patients in control group show more serviously on the symptoms of insomnia and languor (P<0.05); the symptoms of appetite deprivation of patients in both two groups were aggravated, but after the chemotherapy the symptoms of appetite deprivation of patients in experiment was lighter than that in control group, compared with patients in control group, symptoms of insomnia, appetite deprivation and languor in parenteral nutrition group were relieved (P<0.05). Pain and dyspneic respiration in both two groups were improved after chemotherapy, but the differences of two groups after the chemotherapy had no statistical significance; the symptoms of nausea and vomiting, constipation and diarrhea of patients in both two groups were aggravated after the chemotherapy, but the differences of two groups after the chemotherapy had no statistical significance;going alone with adverse affects of chemotherapy, mouth and tongue pains, limbs pricking pain and alopecie occurrence in some patients. However, the number of patients in experiments group who got pain on mouth and tongue were lower than the number in control group(P<0.05).From above, we can summaried that general QOL of patients in experiment group was more than that in control group.②All elderly NSCLC patients clearly appeared malnutrition phenomenon, and worse after the chemotherapy. The quantity of BMI in experimental group after the chemotherapy is 17.8±2.56 kg/m2, and that index of control group after the chemotherapy is 15.1±2.31 kg/m2, and there was statistical difference between two groups(P<0.05).The BMI of all patients were differently decreased after the chemotherapy, and decrease in that index of experimental group had no statistical significance (P<0.05), but there was statistical difference before and after the chemotherapy in control group(P<0.05). Before the chemotherapy, concentrations of ALB, serum PAB, serum transferrin and lymphocyte count(LC) of patients of both two groups of patients were all less than normal, the quantity in experimental group respectively is 39.55±3.94g/L, 181±12.56mg/L, 246±23.71mg/dl and 0.8±0.07×109, and the quantity in control group respectively is 39.48±3.75g/L, 183±15.53mg/L, 242±21.33mg/dl and 0.91±0.12×109, and they were all lower after the chemotherapy than before. After the chemotherapy, level of ALB and serum PAB in experimental group were higher than that in control group (31.83±3.95g/L and 170±9.78mg/L,26.64±3.22g/L and 149±10.56mg/L,respectively, P<0.05), and there is no significan difference in body mass, serum transferrin and lymphocyte count (LC) between two groups after the chemotherapy.Conclusion①Nine-aminofusin (9-AF) plus chemotherapy improved the physical function, emotional function and social function, and relieved the symptoms of insomnia, appetite deprivation and languor, and improve QOL of patients among chemotherapy period.②Almost elderly NSCLC patients exist malnutrition and become worse after chemotherapy. Supplement with amino acids mitigate malnutrition and can sustain the level of BMI after the chemotherapy.③The serum free amino acid content of elderly NSCLC patients generally step down, thus influence protein synthesis, before the chemotherapy, concentrations of ALB, serum PAB, serum transferrin and lymphocyte count (LC) of NSCLC patients were less than normal, and the degree of that were aggravated after the chemotherapy, supplying with 9-aminofusin(9-AF) to support treatment can reduce the degree of decrease above index.
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