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| Application of prerehabilitation nursing practice before radiotherapy in patients with liver cancer: a single-center prospective randomized controlled study |
| Liu L, Xin L, Li W, Duan X, Pi H |
| International Journal of Clinical and Experimental Medicine 2022;15(1):16-22 |
| clinical trial |
| 5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
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OBJECTIVE: To investigate the applicability of prerehabilitation nursing practice before radiotherapy for patients with liver cancer. METHODS: Ninety patients with primary liver cancer who were admitted to The Fifth Medical Center of PLA (Chinese People's Liberation Army) General Hospital from December 2019 to May 2020 and received stereotactic body radiotherapy (SBRT) were selected. On the day of the outpatient visit, all patients were assigned to the observation or control group using a random number table, with 45 patients in each group. Patients in the control group received preoperative instructions before radiotherapy for liver cancer, while those in the observation group received prerehabilitation interventions until the start of radiotherapy. Prerehabilitation interventions included microecological agents for enteral nutrition, Baduanjin exercise, and psychological support for 10 to 15 days. Quality of life instrument for patients with liver cancer (QOL-LC), gripping power weighting index (GPWI), serum albumin (ALB), lymphocyte count, neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) at admission (baseline) and the first day after radiotherapy were compared between the two groups. The GPWI, ALB, QOL-LC and lymphocyte counts were primary measurs, neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) were secondary. Furthermore, we analyzed the correlations between QOL-LC and the HGP/BW ratio, ALB, lymphocyte counts, NLR, and PLR in the two groups. RESULTS: There were no significant differences in baseline QOL-LC scores, GPWI, ALB, lymphocyte counts, NLR and PLR at admission between the two groups (p > 0.05). On the first day after radiotherapy, QOL-LC scores, GPWI, ALB, and lymphocyte counts in the observation group were higher than those in the control group (p < 0.05), while NLR and PLR levels were lower than those in the control group (p < 0.05). The correlation study revealed that QOL-LC scores were positively correlated with the GPWI, ALB and lymphocyte counts in liver cancer patients (p < 0.05), but negatively correlated with NLR and PLR (p < 0.05). CONCLUSIONS: Quality of life in patients with primary liver cancer is significantly associated with nutritional status and immune activity conditions. The application of prerehabilitation nursing practice before radiotherapy in patients with liver cancer can ameliorate their nutritional status and immune activity conditions, increase resistance to radiotherapy and improve perioperative quality of life. Therefore, it is worthy of promotion in clinical practice.
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