营养干预对局部晚期食管癌同步放化疗病人近期疗效及不良反应的影响

樊筱玓; 常芳芳; 孙巧玉; 刘佳; 张莹莹; 崔珍

doi:10.13898/j.cnki.issn.1000-2200.2023.11.009

营养干预对局部晚期食管癌同步放化疗病人近期疗效及不良反应的影响

Effect of nutritional intervention on short-term efficacy and adverse reactions in patients with locally advanced esophageal cancer undergoing concurrent chemoradiotherapy

摘要

摘要:
目的探讨营养干预对具有营养风险的局部晚期食管癌同步放化疗病人近期疗效和不良反应的影响。
方法选取行根治性同步放化疗的局部晚期食管癌病人92例，其中观察组45例，病人行同步放化疗的同时给予积极主动的营养干预；对照组47例，仅行同步放化疗而未给予主动营养干预。比较2组营养状态、近期疗效及同步放化疗并发症等方面的差异。
结果2组各44例病人完成研究。治疗后，观察组白蛋白值明显高于对照组（P < 0.01）；观察组近期疗效优于对照组，放疗敏感组和放疗不敏感组放疗后营养不良发生率差异有统计学意义（P < 0.01）；≥Ⅲ度骨髓抑制率、≥2级放射性食管炎发生率均低于对照组（P < 0.05~P < 0.01）。治疗后营养不良组≥Ⅲ度骨髓抑制率高于营养正常组（P < 0.01）。
结论营养干预是提升具有营养风险的局部晚期食管癌病人近期疗效及减轻不良反应发生程度的重要措施。

Abstract:
ObjectiveTo explore the impact of nutritional intervention on the short-term efficacy and adverse reactions of locally advanced esophageal cancer patients with nutritional risk undergoing concurrent radiotherapy and chemotherapy.
MethodsPatients with locally advanced esophageal cancer who underwent radical concurrent radiotherapy and chemotherapy were selected, including 45 patients in the observation group who received chemoradiotherapy and active nutritional intervention.The control group (47 cases) only received concurrent chemoradiotherapy without active nutritional intervention.The differences in nutritional status, recent efficacy, and complications of concurrent radiotherapy and chemotherapy between the two groups and the control group were compared.
ResultsForty-four patients in each of the group completed the study.After treatment, the albumin value in the observation group was higher than that in the control group (P < 0.01).The short-term efficacy of the observation group was better than that of the control group, and there was a statistically significant difference in the incidence of postoperative malnutrition between the radiation sensitive group and the radiation insensitive group (P < 0.01).The incidence of grade Ⅲ bone marrow suppression and ≥ grade 2 radiation esophagitis in the control group were lower than those in the control group (P < 0.05 to P < 0.01).After treatment, the rate of ≥ Ⅲ degree bone marrow suppression in the malnutrition group was higher than that in the normal nutrition group (P < 0.01).
ConclusionsNutritional intervention may be an important measure to improve the short-term efficacy and reduce the incidence of adverse reactions in locally advanced esophageal cancer patients with nutritional risk.

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