Alterações no estado nutricional segundo IMC e perda de peso, em pacientes com câncer de cabeça e pescoço em uso de terapia nutricional enteral, em ambulatório de oncologia clínica em São Paulo

Abstract

Introduction: Head and neck cancer (HNC) patients constitute a recognized risk group for malnutrition due to several factors, and may require enteral nutritional therapy (ENT). This study evaluated alterations in nutritional status and weight loss in patients with HNC using ENT followed at the Universidade Federal de São Paulo (UNIFESP) oncology outpatient clinic. Methods: This was a retrospective study conducted through database analysis, collected from January to December of 2018 at an UNIFESP oncology outpatient clinic. We selected all patients with HNC in use of ENT at some moment of the treatment during 2018. Weight and height were considered to calculate body mass index (BMI) and to classify nutritional status and the classification of weight loss for evaluation. Results: The sample consisted of 24 patients, 71% were elderly and 29% adults and 75% were men. At the first consultation in 2018, 6 (25%) patients were at normal weight and 15 (63%) had some degree of malnutrition (underweight). A total of 11 (46%) patients reported previous weight loss. After the analysis it was found that 54% of patients had weight loss in the period, however, only 1 patient had severe weight loss. Changes in BMI were observed in all patients, but in 88% of the cases there was no change in BMI classification. Conclusion: Although patients were on ENT, many had weight loss, which may be a result of decreased food intake, metabolic abnormalities caused by tumor activity, or a consequence of treatment-related symptoms. Most of the weight losses were not significant, and most patients had increased body weight, which may have been result of ENT use, which is responsible for delayed weight loss in cancer patients.

A presença de sintomas gastrointestinais e perda de peso como fatores de risco para desnutrição em pacientes com câncer gástrico em tratamento quimioterápico

“…No estudo de Marchiori e Genaro (2017) foi evidenciado que 33% dos pacientes com câncer de estômago apresentaram perda de peso. A perda de peso associada ao câncer ocorre pela redução na ingestão alimentar, assim como pelas alterações metabólicas provocadas pelo tumor (Machado, et al, 2020), dentre elas pode-se citar alterações hormonais, no metabolismo de carboidratos, lipídeos e proteínas, sendo o aumento do gasto energético um fator determinante para perda de peso (Dutra, & Sagrillo, 2014).…”

Campanha: 16 passos para a desospitalização segura

“…O objetivo principal da TN é promover a oferta nutricional adequada a pacientes impossibilitados de atingir suas necessidades calóricas e/ou proteicas através da nutricional oral. Assim, a TN visa otimizar a melhora clínica, com redução de complicações intrahospitalares, tempo de internação e morbimortalidade 58,59 .…”