Principles of nutritional therapy for tumor patients during radiotherapy

Radiotherapy can consume a lot of physical strength, energy and nutrients. Therefore, attention should be paid to nutritional supplementation during radiotherapy to ensure sufficient protein and energy. There is no significant loss of appetite in other parts of the body except for the irradiated abdomen, where there may be loss of appetite and even nausea and vomiting. It is not necessary to restrict the diet too much, but to provide nutritious food in small amounts. Radiotherapy can cause esophageal mucosa congestion and edema, swallowing difficulties, according to the patient’s swallowing situation, with light, less oily thick liquid, such as milk with eggs, lotus root powder with eggs, batter with eggs, crumbled noodles, etc., or with tube feeding meals. In short, the food is processed and cooked to be extremely soft, easy to swallow, and easy to digest and absorb, and attention should be paid to the supplementation of vitamins, minerals and trace elements. If necessary, elemental meals or nutritional preparations of large molecules of whole proteins can be taken. The effect of radiation damage on nutritional metabolism involves energy, sugar, lipids, protein, vitamins, minerals and trace elements, and the degree of effect is related to the severity of radiation damage, and attention should be paid to supplementation. Dietary nutrition When using chemotherapy or radiotherapy, upper digestive system symptoms are often significantly worse than before chemotherapy. There are often aversion to oil, nausea, vomiting, reduced appetite and reduced food intake. Therefore, it is advisable to adjust the dietary nutrition before chemoradiotherapy to increase the nutritional reserve and make the nutrition reach a better state. In order to increase the resistance of the body, the nutritional preparation of elemental diet or large molecule whole protein can be appropriately supplemented. A light, less oily, easily digested and absorbed diet (thick liquid, semi-liquid, soft food and general food according to the patient’s condition) should be given to maintain nutrition so that the patient can tolerate chemotherapy. According to the patient’s specific situation, a reasonably balanced diet should be chosen and a reasonable amount of energy supply should be formulated to meet the needs while avoiding excess. Protein, fat and sugar should account for 12%-15%, 25%-35% and 50% of the total energy respectively; animal and legume proteins account for 30%-50% of the total protein. Food should contain the right amount of dietary fiber, which can prevent lower gastrointestinal tumors such as colon or rectal tumors. The intake of minerals and trace elements should meet the needs of the body, and pay attention to the zinc-copper ratio and calcium-phosphorus ratio. Eat more foods with anti-tumor effects such as fresh vegetables, fruits, dairy, soybean products and mushrooms, silver fungus, black fungus, etc. Drink more tea, quit smoking and limit alcohol. For those who have poor appetite in radiotherapy or chemotherapy, they should insist on eating less and more meals, and use commercially available enteral nutrition preparations if necessary. The dietary principles of radiotherapy for different tumors can be adjusted appropriately, and the common clinical ones are as follows: 1. Gastrointestinal tumors According to the tumor site, a reasonable balanced diet should be chosen, and a reasonable amount of energy supply should be formulated to meet the needs of the body and avoid excessive energy. Protein, fat and sugar should account for 12%-14%, 25%-30% and 65% of the total energy respectively; among them, animal protein and legume protein should account for 30%-50% of the total protein. After gastric tumor surgery, attention should be paid to the use of soft, light and easily digested and absorbed foods, such as egg custard, batter soup, lotus root powder, tofu brain and so on. In order to prevent lower gastrointestinal tumor, food should contain appropriate amount of food fiber, such as colon or rectal tumor, etc. Postoperative diet should pay attention to balanced supply to prevent nutrient deficiency. Vitamins should be adequately supplied, and appropriate amount of fresh vegetables and fruits should be consumed every day; the intake of minerals and trace elements should be able to meet the needs of the body, and pay attention to the zinc-copper and calcium-phosphorus ratio. 2, colon tumor rectal and anal surgery 4 to 5 d before the beginning of the use of less dregs or dregs-free diet, available rice, noodles, lean meat, fish and shrimp, chicken, eggs, etc., can also be used enteral nutrition preparations to reduce the residue in the stool, conducive to postoperative wound healing. From the 2nd postoperative day onwards, patients can be given dregs-free fluids, such as rice soup, lotus root powder, cream of wheat, tofu brain, steamed egg custard, etc., so as to keep the wound clean, reduce infection and pain, and facilitate wound healing. Less residue semi-fluid or soft rice can be given 4-5 d after surgery, and more water can be drunk to keep the stool soft and fluent to prevent wound pain or bleeding caused by dry stool. Dietary treatment is given to high energy, high protein, high sugar, low fat and less residue diet. Give liquid at the beginning, and gradually change to semi-liquid and soft meal as the condition improves. 3.hepatobiliary and pancreatic tumor The diet of liver tumor patients should be mainly high protein, high vitamin and high energy. However, patients with liver dysfunction and liver function loss should follow the medical advice and limit the intake of water, salt and protein. They should quit smoking and alcohol, and not eat fried, spicy and stimulating food. Eat more foods rich in vitamins, minerals and trace elements and dietary fiber, such as fresh vegetables, fruits, mushrooms and seafood. After gallbladder removal, the intake of fat should be limited, and low-fat diet should be chosen, with small amount and multiple meals, and the fat should be controlled below 40g per day. After pancreatic tumor surgery, there may be fat digestion and absorption disorder and blood sugar increase, so low fat and high food fiber diet should be chosen. Eat more green leafy vegetables and fresh fruits, avoid stimulating foods and strong condiments; avoid smoking and quit drinking alcohol, drink more water and tea. You can also use food therapy, the party can be used kiwi root meat stew: take 100g of fresh kiwi root, lean pork 200g, add water with the frying, stewed meat and drink soup. There are clearing heat and detoxification, dampness and blood function. Jin Qian Yin Chen tea: 60g of money grass, 30g of small Yin Chen, 20g of septoria, sugar in the right amount. Wash the above three herbs, put them into a white cloth bag, add water and boil them with a gentle fire to make juice of about 1000 ml, add sugar to make tea. Gynostemma tea: gynostemma tea decoction to make tea. 4.Urological system tumor Choose a balanced diet and develop a reasonable amount of energy supply to meet the needs of the body and avoid too much energy. The distribution ratio of protein, fat and sugar should account for 12%-14%, 25%-30% and 55% of the total energy respectively; among them, animal and legume protein should account for about 50% of the total protein. Food should contain the right amount of dietary fiber, vitamin supply should be adequate, daily intake of fresh vegetables and fruits, such as tomatoes, carrots, cruciferous vegetables, kiwi, etc. and beans and their products, mushroom food; mineral and trace element intake should be able to meet the needs of the body. Choose a low-fat, high-fiber, moderate protein diet, eat more green leafy vegetables and fresh fruits, avoid stimulating foods and strong condiments; avoid smoking and limit alcohol, drink more water, drink more tea. 5, nasopharyngeal tumor Meals should be balanced, eat more vegetables and fruits, and eat less or no salty, pickled and smoked foods. Meals should be light, should not eat spicy and stimulating food. It is not advisable to drink too much alcohol and eat cold and fatty food. Especially for patients during radiotherapy and chemotherapy, easily digestible, nutritious, fresh and delicious foods should be chosen. Bad dietary habits should be changed, and foods containing carcinogenic substances such as canned food, pickled and preserved products, additives, smoked and baked foods should be eaten as little or as much as possible. Special emphasis should be put on eating healthy foods from infants and not eating salted fish, pickles and other tumor-prone foods. Eat more tumor-preventing and healthy natural foods, such as drinking tea often, especially green tea, which can stop the synthesis of carcinogenic substances nitrosamines in the body and prevent nitrosamines from causing tumors. In addition, foods such as grapes, tomatoes, white radish, garlic, shiitake mushrooms and barley have tumor-preventing effects and can be eaten often. The trace elements such as copper and selenium which have anti-tumor effects should be supplemented. Egg yolk, shellfish, snapper, black fungus, etc. are rich in copper; animal liver, kidney, eggs, beans, sesame, etc. are rich in selenium. 6, lung tumor should try to eat less or do not eat canned, preserved products, additives, smoked food and other foods containing tumor-causing substances, and eat less stimulating foods such as chili peppers, raw onions, fatty meat, shrimp and crab. Eat foods rich in vitamin A and C and lung-cleansing foods such as carrots, grapes, lilies, shiitake mushrooms, fried almonds, white fruits, walnuts, asparagus, rooibos, pine nuts, pears, etc. Drink tea, tea can stop tumor-causing substances nitrosamines in the body synthesis and prevent nitrosamines to tumors, drinking tea also has an anti-radiation effect. Eat more grapes: scientists found that grapes contain resveratrol, which can prevent healthy cells from becoming cancerous, resveratrol has a strong anti-tumor effect and can make tumor cells lose their ability to proliferate. Advocate raw and chewy white radish: radish contains anti-tumor and interferon inducer that can stimulate human cells to produce interferon, which has certain anti-tumor effects. Eat more tomatoes, which contain lycopene, can protect humans from tumor-causing substances such as cigarettes and car exhaust, and have a preventive effect on prostate cancer, breast cancer, intestinal cancer, etc. It contains more than 30 kinds of enzymes, 10 kinds of amino acids and anti-tumor trace elements, which can promote the body to induce interferon, improve immune function and enhance anti-tumor effect. Pay attention to the supplementation of trace elements with anti-tumor effect: copper has the effect of blocking nitrosamines. Copper-containing foods such as egg yolk, shellfish, turtle, black wood, etc. Foods rich in selenium, such as animal liver and kidney, eggs, beans and mushrooms, are prone to tumor disease. 7.Multiple myeloma The diet should be light, choose seaweed, nori, wakame, sea clams, almonds and other foods that can inhibit the excessive proliferation of bone marrow, and eat more foods rich in vitamins, minerals, trace elements and food fiber, such as fresh vegetables, fruits, mushrooms and seafood. Pay attention to dietary hygiene and do not come into contact with asbestos, benzene and other toxic and harmful substances. Multiple myeloma has different clinical manifestations, including anemia, bleeding tendency and co-infection. Food therapy prescription for suppressing myeloma overgrowth: peach fish fillet: appropriate amount of green fish meat, 10g of peach kernel crisp, shredded fish meat, stir-fried together. Purple cabbage and turtle soup: 15g of purple cabbage, 150g of turtle meat and appropriate amount of seasoning to cook the soup for consumption. Kelp stew: 100g of seaweed, 100g of pork, add the right amount of seasonings and cook. Commonly used as an accompaniment to meals. Anti-consumption and blood tonic diet: Cordyceps whole duck: 10g Cordyceps, 1 green-headed duck, add 1000ml water, cook for 2 hours on low heat, drink the soup and eat the meat. Eel soup: 2 eels, 2 slices of ginger. Oil and salt seasoning appropriate amount, water decoction boil soup. Commonly used as an accompaniment to meals. Lily porridge: 30g of dried lily, 60g of round-grained rice, add 1000ml of water and cook for l hours on low heat. 8, leukemia As a result of receiving chemotherapy, patients tend to reduce saliva secretion, digestive enzymes are also reduced accordingly, poor taste, often poor appetite, bloating and other symptoms. Therefore, you should choose food with good color, aroma and taste, and easy to digest, and drink more soups such as lean pork and red dates soup, cabbage and pork bone soup. In order to promote appetite, you should often change the pattern of meals. Patients who need to take hormones for a long time are prone to peptic ulcers and osteoporosis. Consuming 600 ml of milk for breakfast every day can neutralize stomach acid, which is beneficial to prevent peptic ulcers. In addition, to prevent osteoporosis, choose foods with high calcium content such as milk, shrimp, soy products, etc. If you receive a bone marrow transplant, you will be treated according to the bone marrow transplant diet. 9.Bone marrow transplantation The diet should be prepared according to the size of the irradiation dose received, the severity of the disease, the stage of the disease and individual differences. Provide adequate nutrition, give high energy, high protein and high vitamin diet, pay attention to the distribution ratio of thermogenic nutrients and nitrogen to heat ratio. Give soft and easily digestible food, avoid mechanical and chemically stimulating food, have small and frequent meals, and gradually increase the amount of meals to protect the gastrointestinal function. Provide sterile diet. Before and after bone marrow transplantation, patients have significantly reduced white blood cell count, decreased phagocytosis, reduced antibodies and immune function, and are prone to infections. Therefore, the food consumed needs to be sterilized before consumption. It is important to pay attention to the amount of food, which should not exceed the patient’s tolerance. Otherwise, it is easy to cause digestive malabsorption, especially for patients with good appetite during the pseudo-healing period, and the amount of food should be increased gradually. At the same time, we should pay attention to the nature of the meal, with less residue and very soft high protein semi-liquid is appropriate, can give milk, chicken puree, steamed egg custard, small meatballs, etc.. All kinds of food should be chopped and cooked, not acid-producing, cold, fried and frying food, in order to reduce the stimulation of the digestive tract. The cooking method uses steam, boil, boil, braise, stew, stew, etc. The homogenized meal is in the form of paste, which is easy to digest and absorb and has the right osmotic pressure, so it does not stimulate the gastrointestinal mucosa and can play a role in protecting the stomach and intestines. In the choice of food can be selected with antioxidant activity and the prevention of radiation damage food such as milk, eggs, animal liver, cauliflower, cabbage, eggplant, lentils, carrots, cucumbers, tomatoes, bananas, apples, yeast, etc.. 10, hematopoietic stem cell transplantation transplant patients in the early post-pretreatment gastrointestinal reactions such as nausea and vomiting, loss of appetite and diarrhea, food intake is reduced, consumption is increased. The nutritional status of the patient deteriorates, which is not conducive to the reconstruction of hematopoiesis and the recovery of the body. Therefore, maintaining the patient’s nutrition is an important part of the treatment. If the patient can eat, it is advisable to give easily digestible high-protein, high-energy, high-vitamin diet; if he cannot eat, it is advisable to give intravenous nutrition, infusion of plasma, amino acid injection, fat emulsion, glucose and electrolytes, etc.