营养干预对食管癌同步放化疗疗效研究  

Effect of nutritional intervention on clinical efficacy of chemoradiotherapy for esophageal carcinoma patients

作　　者：杨丽萍[1] 高劲 周燕[1] 陶振超 何健 杨婧 王如 张洋洋[1] 黄一凡 Yang Liping;Gao Jin;Zhou Yan;Tao Zhenchao;He Jian;Yang Jing;Wang Ru;Zhang Yangyang;Huang Yifan(Department of Radiotherapy,First Affiliated Hospital of University of Science and Technology of China（West Area）（Anhui Cancer Hospital）,Hefei 230000,China)

机构地区：[1]中国科学技术大学附属第一医院(西区)(安徽省肿瘤医院)放疗一科,合肥230000

出　　处：《中华放射肿瘤学杂志》2018年第9期810-813,共4页Chinese Journal of Radiation Oncology

摘　　要：目的 探讨营养干预治疗对食管癌同步放化疗患者疗效的影响.方法 前瞻性纳入2016-2017年安徽省肿瘤医院确诊为食管癌行放疗的患者46例,随机分为常规治疗组与营养干预组（各23例）,观察两组患者放疗前后体重指数（BMI）、主观整体评估（PG-SGA）、血清白蛋白（ALB）、血红蛋白（HB）、白细胞（WBC）等客观营养指标的变化及放疗不良反应发生率.结果 放疗前两组年龄、性别、BMI、ALB、PLT、临床分期等具有可比性（P〉0.05）;营养干预组放疗后BMI较放疗前改善（21.52±2.67、21.13±2.73,P=0.000）;干预组放疗后PG-SGA评分较放疗前明显降低（P=0.000）;常规组放疗后BMI、HB、ALB、PLT、WBC水平较放疗前明显下降,且PG-SGA评分较放疗前更差（P〈0.05）;此外,干预组患者出现3级骨髓抑制发生率显著降低（4.34％：8.68％,P=0.000）.结论 食管癌放疗患者存在较高的营养风险,营养干预治疗可改善患者营养状况,降低放疗不良反应发生率,有可能提高患者生活质量,改善生存预后.Objective To investigate the effect of nutritional intervention upon the clinical efficacy of chemoradiotherapy in patients diagnosed with esophageal carcinoma. Methods A total of 46 patients who were diagnosed with esophageal cancer in Anhui Cancer Hospital from November 2016 to August 2017 were enrolled in this prospective study. All patients were randomly and evenly divided into the nutritional intervention （NI） and routine treatment （RT） groups. The changes in body mass index （BMI）,PG-SGA, serum albumin （ ALB）, hemoglobin （ HB）, white blood cell （ WBC） and other objective nutritional parameters and the incidence of chemoradiotherapy-induced complications were recorded before and after chemoradiotherapy. Results Prior to chemoradiotherapy,age,sex,BMI,ALB,PLT and clinical staging did not significantly differ between two groups （all P〉0. 05）.In the NI group,the BMI was （21.52±2. 67） after chemoradiotherapy,significantly higher than （21.13±2. 73） before radiotherapy （P= 0. 000）.Moreover,the PG-SGA score after chemoradiotherapy was significantly lower compared with that before chemoradiotherapy （P= 0. 000）.In the RT group,the BMI,Hb,ALB,PLT and WBC after chemoradiotherapy were significantly lower than those before radiotherapy, and thePG-SGA score was worse after chemoradiotherapy （ all P〈0. 05）.In the NI group, the incidence of grade 3 myelosuppression was 4. 34%, significantly lower than 8. 68% in the RT group （ P= 0. 000 ）. Conclusions Patients with esophageal cancer treated with chemoradiotherapy have a high nutritional risk. Nutritional intervention can improve the nutritional status, reduce the incidence of chemoradiotherapy-induced complications,and probably improve the quality of life and clinical prognosis.

关 键 词：营养干预 口服营养制剂 食管肿瘤/放射疗法 预后 

分 类 号：R735.1[医药卫生—肿瘤]