癌症预康复理念在超重或肥胖乳腺癌放疗患者中的临床 应用研究  

Application study of cancer prehabilitation in overweight and obese patients with breast cancer undergoing radiotherapy

作　　者：陶伟 王淑安[2] 蒋春雨 张建宇 乔雪 余静仪 陈晓甜[2] Tao Wei;Wang Shu'an;Jiang Chunyu;Zhang Jianyu;Qiao Xue;Yu Jingyi;Chen Xiaotian(Department of Radiotherapy Nanjing Pukou people's Hospital,Nanjing 211800 Jiangsu China;Department of Clinic Nutrition Nanjing Drum Tower Hospital Affiliated Hospital of Nanjing University Medical School,Nanjing 210008 Jiangsu China)

机构地区：[1]南京市浦口人民医院放疗科,南京211800 [2]南京大学医学院附属鼓楼医院临床营养科,南京210008

出　　处：《肿瘤代谢与营养电子杂志》2023年第5期619-625,共7页Electronic Journal of Metabolism and Nutrition of Cancer

基　　金：国家卫生健康委医院管理研究所2023年医疗质量(循证)管理研究项目(YLZLXZ23G129)南京鼓楼医院临床研究专项资金项目(2022-LCYJ-ZX-09)。

摘　　要：目的探究癌症预康复理念对超重或肥胖乳腺癌患者辅助放疗期间营养状态、血脂代谢及并发症的影响。方法选取2020年1月至2022年3月在南京市浦口人民医院放疗科接受辅助放疗的乳腺癌术后患者118例进行回顾性研究,将其分为预康复组(n=63)和对照组(n=55),比较两组血红蛋白、血清白蛋白、甘油三酯、胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、慢性病治疗功能评估-疲劳量表、Jenkins睡眠评估问卷、皮肤毒性反应评估以及疼痛视觉模拟评分法评分。结果放疗过程中,在营养指标方面,两组的血红蛋白水平变化幅度差异无统计学意义(P>0.05),预康复组血清白蛋白水平较对照组维持更好,差异有统计学意义(P<0.05);在血脂代谢方面,预康复组甘油三酯升高幅度低于对照组,差异有统计学意义(P<0.05),而两组总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇变化无统计学意义(P>0.05);并发症方面,预康复组患者FACIT-F评分、JSEQ评分、皮肤毒性反应程度以及疼痛视觉模拟评分法评分指标均优于对照组,差异有统计学意义(P<0.05)。结论在超重或肥胖乳腺癌患者辅助放疗中,乳腺癌策略可能不仅有助于维持营养状态,改善血脂代谢,还可能有助于改善乳腺癌患者相关并发症。Objective To explore the cancer prehabilitation CP concept for overweight or obese breast cancer BC auxiliary during radiotherapy in patients with nutritional status the influence of the blood lipid metabolism and complications.Method A retrospective study was conducted on 118 patients with BC who received adjuvant radiotherapy in the department of radiotherapy of Nanjing Pukou People's Hospital from January 2020 to March 2022.They were divided into prehabilitation group n=63 and control group n=55.The indexes of HB ALB TG TC HDL-C LDL-C FACIT-F score JSEQ score radiation dermatitis and VAS score were compared between the two groups.Result During radiotherapy the hemoglobin level of the two groups decreased without significant difference P>0.05.The serum albumin level of the prehabilitation group was better than the control group P<0.05.In terms of lipid metabolism the increase of TG in the prehabilitation group was lower than the control group P<0.05 while there was no significant difference in TC HDL-C and LDL-C P>0.05.FACIT-F score JSEQ score degree of radiation dermatitis and VAS score of pain in the prehabilitation group were better P<0.05.Conclusion In the adjuvant radiotherapy of overweight or obese BC patients CP may not only help to maintain nutritional status and to improve lipid metabolism but also help to improve the related complications.

关 键 词：癌症预康复 乳腺癌 放射治疗 血脂代谢 并发症 

分 类 号：R737.9[医药卫生—肿瘤]