交互式健康指导移动应用程序预防食管癌患者接受新辅助同步放化疗时营养不良卡塔尔世界杯8强波胆分析和肌肉损失的可行性前瞻性先导研究%A Yang,Kyungmi %A Oh,Dongryul %A Noh,Jae Myoung %A Yoon,Han Gyul %A Sun,Jong-Mu %A Kim,Hong Kwan %A Zo,Jae i %A Shim,Young Mog %A Ko,Hyunyoung %A Lee,Jungeun %A Kim,Youngin %+韩国首尔江南区逸原路81号成均馆大学医学院三星医疗中心放射肿瘤科，06351，韩国，82 233410 2612dongryul.oh@samsung.com %K食管癌%K营养不良%K肌肉损失%K肌肉减少%K移动应用程序%K mHealth %D背景:根据我们之前的研究报道，过度肌肉损失是食管癌患者接受新辅助放化疗(NACRT)的重要预后因素。目的:在这项初步研究中，我们前瞻性地测试了健康指导移动应用程序在这一患者群体中预防营养不良和肌肉损失的可行性。方法:2019年7月至2020年5月，我们招募了38名计划进行NACRT的男性食管癌患者。放疗(RT)开始后的8周内，患者使用Noom，这是一款健康指导移动应用程序，可以交互式地提供有关食物摄入、运动和体重变化的在线建议。基于计算机断层扫描和营养相关实验室标记测量的骨骼肌指数(SMI)在rt前后进行评估。我们评估了使用移动应用程序的患者组(mHealth组)和我们之前的研究队列(常规护理组)之间SMI、营养和炎症因子的变化。此外，我们分析了与应用程序中记录的步行步数相关的因素。结果:两名患者退出研究(未使用应用程序;治疗转向明确目标)。直到试验结束，大约70%(25/36)的患者使用(或激活)了该应用程序。 Compared to the 1:2 matched usual care group by propensity scores balanced with their age, primary tumor location, tumor stage, pre-RT BMI, and pre-RT SMI level, 30 operable patients showed less aggravation of the prognostic nutritional index (PNI) (–6.7 vs –9.8; P=.04). However, there was no significant difference in the SMI change or the number of patients with excessive muscle loss (∆SMI/50 days >10%). In patients with excessive muscle loss, the walk steps significantly decreased in the last 4 weeks compared to those in the first 4 weeks. Age affected the absolute number of walk steps (P=.01), whereas pre-RT sarcopenia was related to the recovery of the reduced walk steps (P=.03). Conclusions: For esophageal cancer patients receiving NACRT, a health care mobile app helped nutritional self-care with less decrease in the PNI, although it did not prevent excessive muscle loss. An individualized care model with proper exercise as well as nutritional support may be required to reduce muscle loss and malnutrition. %M 34448714 %R 10.2196/28695 %U //www.mybigtv.com/2021/8/e28695 %U https://doi.org/10.2196/28695 %U http://www.ncbi.nlm.nih.gov/pubmed/34448714

map