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Abstract：
OBJECTIVE: This study aimed to investigate whether malnutrition or nutrition impact symptoms (NIS) affect the possibility of returning to work after treatment for head and neck cancer.
METHODS: Patients of working age with head and neck cancer were followed up from treatment initiation to 3 months (n = 238), 1 year (n = 182), and 2 years (n = 130) after treatment completion. The observed decrease in the number of patients over time was due to retirement, lack of follow-up, or death. Returning to work was dichotomised as yes or no. Malnutrition was diagnosed 7 weeks after treatment initiation using the Global Leadership Initiative on Malnutrition (GLIM) criteria. This time-point corresponds to the end of chemoradiotherapy or radiotherapy (with or without prior surgery), except for patients who underwent exclusive surgery. NIS were scored on a Likert scale (1-5) at each follow-up using the Head and Neck Patient Symptom Checklist© (HNSC©). Nonparametric tests were used to analyse the ability of patients with/without malnutrition and high/low NIS scores to return to work.
RESULTS: At 3 months, 1 year, and 2 years after treatment completion, 135/238 (56.7%), 49/182 (26.9%), and 23/130 (17.7%) patients had not returned to work. Patients with malnutrition at 7 weeks after treatment initiation were more likely to not return to work at 3 months than those without malnutrition, 70.5% compared to 47.1% (p < 0.001). At all three follow-up time-points, patients reporting high scores for a number of NIS had more often not returned to work, with this pattern being most distinct at 2 years.
CONCLUSIONS: Malnutrition according to the GLIM criteria at 7 weeks after treatment initiation and NIS assessed by the HNSC© at subsequent follow-ups were predictors of the return-to-work process after treatment for up to 2 years.
BACKGROUND: ClinicalTrials.gov NCT03343236 (date of registration 17/11/2017).
METHODS: Patients of working age with head and neck cancer were followed up from treatment initiation to 3 months (n = 238), 1 year (n = 182), and 2 years (n = 130) after treatment completion. The observed decrease in the number of patients over time was due to retirement, lack of follow-up, or death. Returning to work was dichotomised as yes or no. Malnutrition was diagnosed 7 weeks after treatment initiation using the Global Leadership Initiative on Malnutrition (GLIM) criteria. This time-point corresponds to the end of chemoradiotherapy or radiotherapy (with or without prior surgery), except for patients who underwent exclusive surgery. NIS were scored on a Likert scale (1-5) at each follow-up using the Head and Neck Patient Symptom Checklist© (HNSC©). Nonparametric tests were used to analyse the ability of patients with/without malnutrition and high/low NIS scores to return to work.
RESULTS: At 3 months, 1 year, and 2 years after treatment completion, 135/238 (56.7%), 49/182 (26.9%), and 23/130 (17.7%) patients had not returned to work. Patients with malnutrition at 7 weeks after treatment initiation were more likely to not return to work at 3 months than those without malnutrition, 70.5% compared to 47.1% (p < 0.001). At all three follow-up time-points, patients reporting high scores for a number of NIS had more often not returned to work, with this pattern being most distinct at 2 years.
CONCLUSIONS: Malnutrition according to the GLIM criteria at 7 weeks after treatment initiation and NIS assessed by the HNSC© at subsequent follow-ups were predictors of the return-to-work process after treatment for up to 2 years.
BACKGROUND: ClinicalTrials.gov NCT03343236 (date of registration 17/11/2017).
摘要：
目的：本研究旨在调查营养不良或营养影响症状（NIS）是否会影响头颈部癌症治疗后重返工作岗位的可能性。
方法：从治疗开始到3个月，对工作年龄的头颈癌患者进行随访（n=238），1年（n=182），治疗完成后2年（n=130）。随着时间的推移，观察到的患者数量减少是由于退休，缺乏后续行动，或死亡。重返工作岗位被分为是或否。在开始治疗后7周，使用全球领导力营养不良倡议（GLIM）标准诊断出营养不良。该时间点对应于放化疗或放疗结束（有或没有手术），除了接受独家手术的患者。在每次随访中使用头颈部患者症状检查表(HNSC)在Likert量表(1-5)上对NIS进行评分。非参数检验用于分析有/没有营养不良和高/低NIS评分的患者重返工作的能力。
结果：在3个月时，1年,治疗完成后2年，135/238（56.7%），49/182（26.9%），23/130（17.7%）患者没有重返工作岗位。治疗开始后7周营养不良的患者比没有营养不良的患者更有可能在3个月后不恢复工作。70.5%与47.1%相比(p<0.001)。在所有三个随访时间点，报告许多NIS得分高的患者通常没有重返工作岗位，这种模式在2年内最为明显。
结论：在治疗开始后7周，根据GLIM标准的营养不良和在随后的随访中由HNSC©评估的NIS是治疗后长达2年的重返工作过程的预测因子。
背景：ClinicalTrials.govNCT03343236（注册日期17/11/2017）。
方法：从治疗开始到3个月，对工作年龄的头颈癌患者进行随访（n=238），1年（n=182），治疗完成后2年（n=130）。随着时间的推移，观察到的患者数量减少是由于退休，缺乏后续行动，或死亡。重返工作岗位被分为是或否。在开始治疗后7周，使用全球领导力营养不良倡议（GLIM）标准诊断出营养不良。该时间点对应于放化疗或放疗结束（有或没有手术），除了接受独家手术的患者。在每次随访中使用头颈部患者症状检查表(HNSC)在Likert量表(1-5)上对NIS进行评分。非参数检验用于分析有/没有营养不良和高/低NIS评分的患者重返工作的能力。
结果：在3个月时，1年,治疗完成后2年，135/238（56.7%），49/182（26.9%），23/130（17.7%）患者没有重返工作岗位。治疗开始后7周营养不良的患者比没有营养不良的患者更有可能在3个月后不恢复工作。70.5%与47.1%相比(p<0.001)。在所有三个随访时间点，报告许多NIS得分高的患者通常没有重返工作岗位，这种模式在2年内最为明显。
结论：在治疗开始后7周，根据GLIM标准的营养不良和在随后的随访中由HNSC©评估的NIS是治疗后长达2年的重返工作过程的预测因子。
背景：ClinicalTrials.govNCT03343236（注册日期17/11/2017）。
