Abstract:【Objective】To investigate the effects of different nutritional support programs on adverse reactions during concurrent chemoradiotherapy in patients with esophageal cancer.【Methods】A total of 96 patients with esophageal cancer treated in our hospital were randomly divided into the observation group and the control group,with 48 cases in each group. The patients in the control group were given oral nutrients in addition to regular diet,and the patients in the observation group were given enteral nutrition support in addition to routine diet. The treatment effect,adverse reactions during treatment,body mass index (BMI),subjective global assessment scale (PG-SGA) score,serum albumin (ALB),hemoglobin (Hb),serum transferrin (TF) and T lymphocyte (CD4+,CD8+,CD4+/CD8+) levels before and after treatment were compared between the two groups.【Results】There was no significant difference in the effective rate of treatment between the two groups (P>0.05). After treatment,the BMI and PG-SGA score in the observation group were higher than those before treatment. The BMI in the control group was lower than that before treatment,and the PG-SGA score in the control group was higher than that before treatment (P<0.05). After treatment,the BMI of the observation group was higher than that of the control group,and the PG-SGA score was lower than that of the control group (P<0.05).The levels of ALB,Hb and TF in the observation group after treatment were higher than those before treatment,and those in the control group were lower than those before treatment (P<0.05). After treatment,there were no significant differences in CD4+,CD8+,CD4+/CD8+ in the observation group compared with those before treatment (P>0.05). Both CD4+ and CD4+/CD8+ in the control group were lower than those before treatment and the observation group (P<0.05),and there was no significant difference in CD8+ among those comparisons (P>0.05). The incidences of infection and myelosuppression≥grade 3 in the observation group were significantly lower than those in the control group (P<0.05). There was no significant difference in the incidence of radiation pneumonitis≥grade 3 and radiation esophagitis≥grade 3 between the two groups (P<0.05).【Conclusion】Enteral nutrition support program for patients with esophageal cancer during concurrent radiotherapy and chemotherapy can improve nutritional status,enhance immune function,reduce the incidence of infection and myelosuppression,and improve radiotherapy and chemotherapy tolerance.
韦玲艳, 孙凤娟, 张营, 曲向晖, 李明芝. 不同营养支持方案对食管癌患者同步放化疗期间不良反应的影响[J]. 医学临床研究, 2022, 39(8): 1213-1216.
WEI Ling-yan, SUN Feng-juan, ZHANG Ying, et al. Effects of Different Nutritional Support Programs on Adverse Reactions during Concurrent Chemoradiotherapy in Patients with Esophageal Cancer. JOURNAL OF CLINICAL RESEARCH, 2022, 39(8): 1213-1216.
[1] CHUN S,SKINNER H,MINSKY B.Radiation therapy forlocally advanced esophagealcancer[J].Surg Oncol Clin N Am,2017,26(2):257-276. [2] BRETÓN M J O,PÉREZ L M L,Virizuela J A,et al. Nutritional support and parenteral nutrition in cancer patients:An expert consensus report[J].Clin Transl Oncol,2018,65(1):17-23. [3] 中华医学会消化内镜学分会,中国抗癌协会肿瘤内镜专业委员会. 中国早期食管癌筛查及内镜诊治专家共识意见(2014年,北京)[J].中国实用内科杂志,2015,35(4):320-337. [4] 杨学宁,吴一龙. 实体瘤治疗疗效评价标准-RECIST[J].循证医学,2004,4(2):85-90. [5] MATSUOKA M,IIJIMA S . Consideration of nutritional support for decreased caloric intake in patients with severe weight loss after esophageal cancer surgery[J].Gan To Kagaku Ryoho,2019,46(1):132-134. [6] 黄玉胜,吴亚从,宋一雪,等. 肠内营养支持对食管癌同步放化疗患者营养状况及免疫功能作用研究[J].现代医药卫生,2018,34(14):2111-2115. [7] 陈越芬,刘倩,练映霞. 肠内营养支持对老年呼吸衰竭患者营养状态和免疫球蛋白及T细胞亚群的影响[J].内科,2017,12(2):164-168. [8] 肖丽华,苏菁菁,吴敏,等. 肠内营养支持对食管癌同期放化疗患者营养状态的影响[J].吉林医学,2018,39(7):1351-1352. [9] 陈超,李华峰. 肠内营养支持治疗对食管癌放化疗疗效的影响[J].浙江中西医结合杂志,2014,24(7):611-612. [10] SUNPAWERAVONG S,PUTTAWIBUL P,RUANGSIN S,et al. Randomized study of anti inflammatory and immune-modulatory effects of enteral immunonutrition during concurrent chemoradiotherapy for esophageal cancer[J].Nutr Cancer,2014,66(1):1-5. [11] 李世伟,杨守梅,李苏宜. ω-3多不饱和脂肪酸对改善肿瘤患者临床结局的研究进展[J].肠外与肠内营养,2014,21(5):313-314. [12] 朱小平,王燕,何慧娟. 肠内营养与肠外营养对放疗食管癌患者的营养改善效果研究[J].中国药物与临床,2019,19(15):2590-2592. [13] 吕家华,谢丛华,申良方,等. 肠内营养对食管癌同步放化疗患者营养状况、不良反应和近期疗效影响:前瞻性、多中心、随机对照临床研究(NCT02399306)[J].中华放射肿瘤学杂志,2018,27(1):44-48.