论文部分内容阅读
目的通过对食管癌放疗联合化疗患者进行营养评估,探讨食管癌放化疗患者营养风险增加的相关因素,以便于临床及时给予营养干预和监测,进而指导个体化的营养支持提供科学依据。方法选择2014年7月—2015年7月浙江省肿瘤医院符合纳入营养风险筛查的97例食管癌放疗患者为研究对象,运用欧洲营养风险筛查工具(NRS-2002)对患者入院时、放疗第1周至第6周进行营养风险筛查,分析其相关性,评价食管癌放化疗患者的营养状态。结果 26.8%的患者在放化疗前就存在营养风险,这种风险随着放化疗的进行而逐渐升高,至放疗第6周,达到44.8%;入院时NRS-2002评分≤3分和≥4分的患者,1年总生存分别为91.1%和61.9%(P=0.010),治疗期间NRS-2002评分最高分≤2分和≥3分患者1年总生存分别为94.2%和77.5%(P=0.012),治疗期间NRS-2002评分最低分≤3分和≥4分患者1年总生存分别为93.0%和55.0%(P=0.009);入院时和放疗第1周NRS-2002评分与前白蛋白有关(P<0.001,P=0.002),放疗第3周NRS-2002评分与白蛋白有关(P=0.036)。结论食管癌放疗联合化疗患者存在较高的营养风险,影响患者治疗进程和治疗效果,因此,进行及时有效的营养评估及干预至关重要。
Objective To evaluate the nutritional risk of esophageal cancer radiotherapy and chemotherapy in patients with esophageal cancer through radiotherapy and chemotherapy combined with chemotherapy in order to provide scientific basis for nutritional intervention and monitoring in a timely manner and to guide personalized nutrition support. Methods From July 2014 to July 2015, 97 patients with esophageal cancer who underwent nutritional risk screening in Zhejiang Cancer Hospital were enrolled in the study. The European Nutrition Risk Screening Tool (NRS-2002) Week 1 to week 6 nutritional risk screening, analysis of their relevance to evaluate the nutritional status of patients with esophageal cancer radiotherapy and chemotherapy. Results Twenty-six percent of patients had nutrition risk before radiotherapy and chemotherapy. The risk increased gradually with radiotherapy and chemotherapy, reaching 44.8% by the sixth week of radiotherapy. On admission, NRS-2002 score ≤3 and ≥4 The overall 1-year overall survival was 91.1% and 61.9%, respectively (P = 0.010). The overall 1-year overall survival was 94.2% and 77.5%, respectively, for patients with NRS-2002 scores of ≤2 and ≥3 (P = 0.012). The 1-year overall survival was 93.0% and 55.0% (P = 0.009) for the patients with the lowest NRS-2002 score of 3 or more and 4 or more points during treatment. The scores of NRS- Albumin (P <0.001, P = 0.002). The NRS-2002 score was associated with albumin in the third week of radiotherapy (P = 0.036). Conclusions Patients with esophageal cancer radiotherapy combined with chemotherapy have a higher nutritional risk and affect the course of treatment and the therapeutic effect of the patients. Therefore, timely and effective nutritional assessment and intervention are essential.