食管癌放疗联合化疗患者营养状况相关性因素分析  

Correlation factor analysis of nutritional status for esophageal cancer patients receiving chemoradiotherapy

作　　者：邵秋月[1] 谢淑萍[1] 沈佳琴[1] 王谨[1] SHAO Qiu-yue XIE Shu-ping SHEN Jia-qin et al.(Department of Thoracil Radiation Therapy, Zhejiang Cancer Hospital Hangzhou , Zhefiang 310022, China)

机构地区：[1]浙江省肿瘤医院胸部放疗科,浙江杭州310022

出　　处：《中华全科医学》2017年第9期1589-1591,1608,共4页Chinese Journal of General Practice

基　　金：2012年度浙江省医药卫生科技计划项目(2012KYA-024)

摘　　要：目的通过对食管癌放疗联合化疗患者进行营养评估,探讨食管癌放化疗患者营养风险增加的相关因素,以便于临床及时给予营养干预和监测,进而指导个体化的营养支持提供科学依据。方法选择2014年7月—2015年7月浙江省肿瘤医院符合纳入营养风险筛查的97例食管癌放疗患者为研究对象,运用欧洲营养风险筛查工具(NRS-2002)对患者入院时、放疗第1周至第6周进行营养风险筛查,分析其相关性,评价食管癌放化疗患者的营养状态。结果 26.8%的患者在放化疗前就存在营养风险,这种风险随着放化疗的进行而逐渐升高,至放疗第6周,达到44.8%;入院时NRS-2002评分≤3分和≥4分的患者,1年总生存分别为91.1%和61.9%(P=0.010),治疗期间NRS-2002评分最高分≤2分和≥3分患者1年总生存分别为94.2%和77.5%(P=0.012),治疗期间NRS-2002评分最低分≤3分和≥4分患者1年总生存分别为93.0%和55.0%(P=0.009);入院时和放疗第1周NRS-2002评分与前白蛋白有关(P<0.001,P=0.002),放疗第3周NRS-2002评分与白蛋白有关(P=0.036)。结论食管癌放疗联合化疗患者存在较高的营养风险,影响患者治疗进程和治疗效果,因此,进行及时有效的营养评估及干预至关重要。Objective To explore the related factors of the increasing nutritional risk in esophageal cancer patients receiv- ing chemoradiotherapy by means of nutrition assessment, facilitating the timely nutrition monitoring and intervention, and providing scientific basis for individualized nutritional support. Methods Between July,2014 and July,2015,97 patients with esophageal cancer who were screened for nutritional risk were selected as the subjects. We used the European nutri- tional risk screening tool （NRS-2002） to screen nutrition risk of patients at admission and during the first to sixth week of radiotherapy, and then analyzed their correlation, as well as evaluating the nutritional status of those patients. Results Twenty-seven percent of the subjects had nutritional risk before chemoradiotherapy. This risk was gradually increased dur- ing chemoradiotherapy ,reaching 44.8% at the sixth week. For patients whose NRS-2002 score was ≤3 point and ≥4 point at＂ admission, 1 year overall survival rate was 91.1% and 61.9 % respectively （ P = 0.010）. For patients whose high- est NRS-2002 score was ≤2 point and ≥3 point during treatment, 1 year overall survival rate was 94.2% and77.5% re- spectively（P = 0. 012）. For patients whose lowest NRS-2002 score was ≤3 point and ≥4 point during treatment, 1 year overall survival rate was 93 % and 55 % respectively （P = 0. 009）. The NRS-2002 score at admission and the first week of radiotherapy was associated with the pre-albumin level（P = 0. 000,0. 002）. The NRS-2002 score was associated with al- bumin at the third week of radiotherapy （ P = 0. 036）. Conclusion Esophageal cancer patients who receive chemoradio- therapy have higher nutritional risk, influencing the treatment process and effect. Therefore, timely and effective nutrition assessment and intervention is very important.

关 键 词：食管癌 放疗 化疗 营养状况 

分 类 号：R735.1[医药卫生—肿瘤] R730.53[医药卫生—临床医学]