管饲营养支持治疗在食管癌同步放化疗患者中的回顾性分析  

Retrospective analysis of tube feeding nutritional supportive therapy in patients with concurrent chemoradiotherapy for esophageal cancer

作　　者：欧阳淑玉 陈珏 李华 田汨 贺礼理 OUYANG Shuyu;CHEN Jue;LI Hua;TIAN Mi;HE Lili(Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine,Central South University,Changsha,410000,Hunan,China)

机构地区：[1]湖南省肿瘤医院/中南大学湘雅医学院附属肿瘤医院,湖南长沙410013

出　　处：《肿瘤药学》2024年第5期607-613,共7页Anti-Tumor Pharmacy

基　　金：湖南省自然科学基金项目(2024JJ9272)。

摘　　要：目的回顾性分析对比有无管饲营养支持治疗对食管癌同步放化疗患者营养状况、不良反应、费用及预后的影响。方法收集湖南省肿瘤医院2013年1月至2022年12月收治的62例食管癌同步放化疗患者的临床及随访资料,分为管饲组和无管饲组,比较两组患者在同步放化疗期间的营养状况、费用及预后。结果管饲组患者同步化疗次数和同步免疫治疗完成例数均显著高于无管饲组(P<0.05),其余临床指标比较,差异无统计学意义(P>0.05)。无管饲组患者营养风险筛查(NRS)2002评分≥3分、发生≥3级放射性食管炎及骨髓抑制、食管穿孔的例数均显著高于管饲组(P<0.05)。管饲组与无管饲组患者放化疗期间血红蛋白出现最低值的平均时间分别为第33.5天和第27.25天,血小板出现最低值的平均时间分别为第26.43天和第20.03天,差异均有统计学意义(P<0.05)。管饲组患者放疗中断的平均时间显著短于无管饲组(P<0.05)。管饲组患者营养费用占比高于无管饲组,但抗菌药物、细胞因子费用占比均低于无管饲组,差异有统计学意义(P<0.05)。Kaplan-Meier生存曲线显示,管饲组与无管饲组中位PFS分别为37.08个月和18.35个月,中位OS分别为59.28个月和24.16个月,差异均有统计学意义(P<0.05)。结论管饲营养治疗可改善食管癌同步放化疗患者营养状况,减少严重不良反应发生率及放疗中断时间,延缓出现血红蛋白、血小板最低值的时间,患者同步放化疗完成率更高,预后更好,同时降低辅助治疗药物费用。Objective To retrospectively analyze and compare the nutritional status,adverse reactions,costs,and prog-nosis of esophageal cancer patients with or without tube feeding nutritional support during concurrent chemoradiotherapy.Methods Clinical and follow-up data of 62 patients with concurrent chemoradiotherapy for esophageal cancer at Hunan Cancer Hospital were collected from January 2013 to December 2022.The patients were divided into the tube feeding group and the non-tube feeding group.The nutritional status,costs,and prognosis of patients in both groups during concur-rent chemoradiotherapy for esophageal cancer were compared.Results The number of completed cycles of concurrent che-motherapy and the cases with completed concurrent immunotherapy were higher in the tube feeding group than in the non-tube feeding group(P<0.05).There were no differences in the remaining clinical characteristics between the two groups(P>0.05).The cases of Nutritional Risk Screening(NRS)2002 scores≥3,with≥3 grade radiation esophagitis,bone marrow sup-pression and esophageal perforation in the non-tube feeding group was significantly more than in the tube feeding group(P<0.05).The average time for the lowest hemoglobin level appeared since concurrent chemoradiotherapy was 33.5 days in the tube feeding group and 27.25 days in the non-tube feeding group(P<0.05).The average time for the lowest platelet level ap-peared since concurrent chemoradiotherapy was respectively 26.43 days and 20.03 days in the tube and non-tube feeding group(P<0.05).The average time of interruption of radiation therapy in the tube feeding group was significantly shorter than in the non-tube feeding group(P<0.05).The proportion of nutrition costs was higher in the tube feeding group than in the non-tube feeding group,but the proportion of antibacterial drug costs and cytokine costs was lower in the tube feeding group than in the non-tube feeding group(P<0.05).Kaplan-Meier survival curves showed that the median PFS was 37.08 months in the tube feeding group and

关 键 词：食管癌 管饲 营养支持治疗 同步放化疗 营养状况 

分 类 号：R735.1[医药卫生—肿瘤]