营养干预对脑转移瘤的放疗患者疗效的评价研究  

Evaluation of the Effect of Nutritional Intervention on Patients with Brain Metastases Undergoing Radiotherapy

作　　者：杭业 宋锦 孙开国 陈金忠 徐卫炜 HANG Ye;SONG Jin;SUN Kaiguo;CHEN Jinzhong;XU Weiwei(Radiation Oncology Department,Yancheng Clinical Medical College of Nanjing Medical University(Yancheng Third People's Hospital,China),Yancheng,Jiangsu 224000,China)

机构地区：[1]南京医科大学盐城临床医学院(盐城市第三人民医院)肿瘤放射治疗科,江苏盐城224000

出　　处：《临床研究》2025年第3期81-85,共5页Clinical Research

基　　金：江苏医药临床学院(盐城市第三人民医院)科研项目(202119143)。

摘　　要：目的探讨营养干预对脑转移瘤(BM)放疗患者疗效的影响。方法前瞻性纳入2022年1月至2024年2月在南京医科大学盐城临床医学院(盐城市第三人民医院)确诊为BM并接受放疗的72例患者,采用随机数表法将其分为干预组与对照组,各36例。观察两组患者放疗前后体质量指数(BMI)、主观整体评估量表(PG-SGA)、血清白蛋白(ALB)、血红蛋白(HB)、白细胞计数(WBC)、血小板计数(PLT)的变化及放疗不良反应发生率。结果放疗前两组患者的年龄、性别、居住地、BMI、吸烟史、1年内有无手术史、是否同期化疗、肿瘤类型、癌症分期、病程资料比较差异均无统计学意义,具有可比性(P>0.05);放疗后,干预组患者的PG-SGA评分、HB水平降低,放疗前后比较,差异有统计学意义(P<0.05);放疗后,对照组患者的PG-SGA评分升高,ALB、HB、WBC、PLT降低,放疗前后比较,差异有统计学意义(P<0.05);放疗后,干预组患者的PG-SGA评分低于对照组,BMI、HB、ALB、WBC及PLT水平均高于对照组,差异有统计学意义(P<0.05);干预组患者≥3级骨髓抑制发生率较对照组降低(干预组患者≥3级骨髓抑制发生率为13.89%,对照组患者≥3级骨髓抑制发生率为38.89%,P=0.016)。结论营养干预能够显著改善脑转移瘤放疗患者的营养状况,减轻放疗对患者血液学指标的负面影响,并降低严重骨髓抑制的发生率。Objective To explore the impact of nutritional intervention on the efficacy of radiotherapy in patients with brain metastases(BM).Methods Seventy-two patients diagnosed with BM who received radiotherapy at Yancheng Clinical Medical College of Nanjing Medical University(Yancheng Third People's Hospital)from January 2022 to February 2024 were prospectively included.Patients were randomly divided into an intervention group and a control group,with 36 cases in each group.Changes in body mass index(BMI),the Subjective Global Assessment Scale(PG-SGA),serum albumin(ALB),hemoglobin(HB),white blood cell count(WBC),and platelet count(PLT)before and after radiotherapy,as well as the incidence of radiotherapy-related adverse reactions,were observed.Results Before radiotherapy,there were no statistically significant differences between the two groups in age,sex,residence,BMI,smoking history,surgical history within the past year,concurrent chemotherapy,tumor type,cancer stage,or course of disease(P>0.05),indicating comparability.After radiotherapy,the PG-SGA score and HB level in the intervention group decreased,and the difference was statistically significant(P<0.05).In the control group,the PG-SGA score increased,while ALB,HB,WBC,and PLT levels decreased,with significant differences before and after treatment(P<0.05).After treatment,the PG-SGA score in the intervention group was lower than that in the control group,and levels of BMI,HB,ALB,WBC,and PLT were higher in the intervention group,with statistical significance(P<0.05).The incidence of≥grade 3 bone marrow suppression in the intervention group was lower than that in the control group(13.89%vs.38.89%,P=0.016).Conclusion Nutritional intervention can significantly improve the nutritional status of patients with brain metastases undergoing radiotherapy,mitigate the negative impacts of radiotherapy on hematological parameters,and reduce the incidence of severe bone marrow suppression.

关 键 词：营养干预 脑转移瘤 放疗 预后 

分 类 号：R739.9[医药卫生—肿瘤]