营养风险筛查工具（NRS-2002）对不可手术的食管鳞癌患者同步放化疗疗效和不良反应的相关性分析  

Correlation analysis between the Nutritional Risk Screening Tool （NRS-2002）;and clinical efficacy and adverse events of concurrent chemoradiotherapy for the esophageal squamous cell carcinoma patients

作　　者：詹文明[1] 陈芳洁[2] 贾勇士[1] 吴颖[2] 戎惠[2] 余黎[2] 李渊[2] Zhan Wenming;Chen Fangjie;Jia Yongshi;Wu Ying;Rong Hui;Yu Li;Li Yuan(Department of Radiation Oncology,Department of Nursing,Zhejiang Provincial People＇s Hospital,People＇s Hospital of Hangzhou Medical College,Hangzhou 310014,China)

机构地区：[1]浙江省人民医院杭州医学院附属人民医院放疗科,杭州310014 [2]浙江省人民医院杭州医学院附属人民医院护理部,杭州310014

出　　处：《中华放射肿瘤学杂志》2018年第8期734-739,共6页Chinese Journal of Radiation Oncology

摘　　要：目的研究营养风险筛查工具（NRS-2002）对不可切除的局部晚期食管鳞癌（LAESCC）患者接受同步放化疗治疗的疗效及生存结果影响。方法回顾性分析2013—2015年浙江省人民医院放疗科行根治性同步放化疗治疗的LAESCC患者105例，营养状况的筛查使用营养风险筛查lT具NRS-2002量表，率间比较采用疋。检验，Kaplan—Meier法计算生存率，Logrank法检验，Cox回归模型预后因素分析。结果37．1％的患者在同步放化疗前就存在营养风险，NRS-2002评分≥3分的患者／〉3级不良反应发生率显著高于评分为1～2分者（P=0．007），所有患者的中位生存（OS）和无进展生存（PFS）分别为17．0个月和11．8个月，NRS-2002评分≥3分组的患者0s和PFS均显著低于评分为1-2分者（均P=0．000），进一步行多因素分析发现，评分≥3分是OS（P=0．000）和PFS（P=0．001）降低的独立预后因素。结论NRS-2002工具表明食管癌患者存在较高营养风险，而治疗前评分≥3分提示与不良反应增加及生存降低显著相关，值得进一步研究和应用。Objective To investigate the effect of nutritional risk screening tool （NRS-2002） upon the clinical efficacy and survival outcomes in patients with unresectable locally advanced esophageal squamous ceil carcinoma （LAESCC） receiving concurrent claemoradiotherapy. Methods Clinical data of 105 LAESCC patients treated with concurrent chemoradiotherapy in Zhejiang Provincial People＇s Hospital from January 2013 to December 2015 were retrospectively analyzed. Nutritional status screening was performed using the NRS-2002 scale. The rate comparison was analyzed by using chi-square test. Kaplan- Meier survival analysis was adopted to calculate the survival rate. Log-rank test was utilized to statistically analyze the differences in survival outcomes. Cox regression model was used for uni-and multi-variate analyses. Results Prior to concurrent chemoradiotherapy, 37. 1% of patients had the nutritional risk. Patients with NRS-2002 score ≥ 3 had a significantly higher incidence of ≥ grade 3 toxic reactions compared with their counterparts obtaining NRS-2002 score of 1-2（ P = 0. 007）.The median overall survival （OS） and progression-free survival （PFS） of all patients were 17.0 and 11.8 months. The OS and PFS of patients with NRS-2002 score ≥ 3 were significantly lower than those of their counterparts obtaining NRS-2002 score of 1- 2（ both P= 0. 000）. Multivariate analysis demonstrated that NRS-2002 score of ≥ 3 was an independent prognostic factor for OS （ P = 0. 000 ） and PFS （ P = 0. 001 ）. Conclusions NRS-2002 tool reveals that patients with esophageal cancer possess a relatively high nutritional risk. Prior to treatment, NRS-2002 score of ≥ 3 is significantly correlated with an increasing risk of toxic reactions and decreasing survival rate, which is worthy of subsequent investigation.

关 键 词：食管肿瘤/同步放化疗法 营养风险筛查工具 预后 

分 类 号：R473.73[医药卫生—护理学]