[1]朱琪伟,王向前,杨磊,等.围放疗期全程营养管理在腹部肿瘤领域的应用及对营养现状、T细胞亚群、KPS评分的影响[J].肠外与肠内营养杂志,2021,(04):211-215.[doi:10.16151/j.1007-810x.2021.04.005]
 ZHU Qi-wei,WANG Xiang-qian,YANG Lei,et al.Application of whole-course nutritional management in the periradiation period and its effects on the nutritional status, T cell subsets and KPS score of the patients with abdominal tumors[J].PARENTERAL & ENTERAL NUTRITION,2021,(04):211-215.[doi:10.16151/j.1007-810x.2021.04.005]
点击复制

围放疗期全程营养管理在腹部肿瘤领域的应用及对营养现状、T细胞亚群、KPS评分的影响
分享到:

《肠外与肠内营养》杂志[ISSN:1007-810X/CN:32-1477/R]

卷:
期数:
2021年04期
页码:
211-215
栏目:
论著
出版日期:
2021-07-10

文章信息/Info

Title:
Application of whole-course nutritional management in the periradiation period and its effects on the nutritional status, T cell subsets and KPS score of the patients with abdominal tumors
作者:
朱琪伟 1王向前 1杨磊 2杨燕光 1丁华 1金华 3
南通大学附属肿瘤医院,1.放疗科;2.营养科;3.精准医学临床研究中心,江苏南通 226361
Author(s):
ZHU Qi-wei 1 WANG Xiang-qian 1 YANG Lei 2 YANG Yan-guang 1 DING Hua 1 JIN Hua 3
1. Department of radiotherapy, 2. Department of nutrition, 3. Clinical research center of precision medicine, Cancer Hospital of Nantong University, Nantong,226361, Jiangsu, China
关键词:
放疗 全程营养管理 腹部肿瘤 营养现状 T细胞亚群 Karnofsky功能状态
Keywords:
Radiotherapy Whole course nutritional management Abdominal tumor Nutritional status T cell subsets Karnofsky performance status
分类号:
R459.3
DOI:
10.16151/j.1007-810x.2021.04.005
文献标志码:
A
摘要:
目的:探讨围放疗期全程营养管理在腹部肿瘤领域的应用及对营养现状、T细胞亚群、Karnofsky功能状态(KPS)评分的影响。方法:选取2019年1月至2020年7月本院收治的152例腹部肿瘤放疗病人进行前瞻性研究,随机数字表法分为对照组、观察组,各76例。对照组给予常规营养指导,观察组在此基础上给予围放疗期全程营养管理。比较两组营养现状[血红蛋白(Hb)、血清白蛋白(Alb)、前白蛋白(PAB)]、细胞免疫功能(CD4+、CD4+/CD8+、总B淋巴细胞、NK细胞、总T淋巴细胞)、KPS评分、患者主观整体评估(PG-SGA)评分、放疗毒副反应。结果:观察组干预后Hb、Alb、PAB高于对照组(P < 0.05)。与对照组比较,观察组干预后CD4+、CD4+/CD8+、总B淋巴细胞、NK细胞、总T淋巴细胞更高(P < 0.05)。观察组干预后KPS、PG-SGA评分优于对照组(P < 0.05)。观察组放疗毒副反应发生率11.84%低于对照组38.16%(P < 0.05)。结论:全程营养管理可有效减轻放疗对腹部肿瘤细胞免疫功能的影响,从而调节营养状态,延缓营养不良进程,减少毒副反应发生。
Abstract:
Objective: To investigate the application of whole-course nutritional management during the peri radiation therapy field of abdominal tumors and its influences on nutritional status, T cell subsets, and Karnofsky performance status (KPS) score of the patients. Methods: From January 2019 to July 2020, 152 patients with abdominal tumors who received radiotherapy in our hospital were prospectively recruited in this study. The patients were randomly divided into the control and observation groups(n = 76 each group). The control group was treated with routine nutritional guidance, and the observation group was given with whole-course nutritional management during the peri-radiation period. The nutritional status, cellular immune function, KPS scores, patient-generated subjective global assessment (PG-SGA) score, and toxic side-effects of radiotherapy were evaluated in the patients. Results: The serum levels of hemoglobin (Hb), serum albumin (Alb), prealbumin (PAB) after radiotherapy were higher in the observation group than in the control group (P < 0.05). Compared with the control group, the percentage of CD4+ T cells, CD4+/CD8+ ratios, and the counts in total B lymphocytes, NK cells, and total T lymphocytes were also higher in the observation group after radiotherapy (P < 0.05). The KPS and PG-SGA scores in the observation group after intervention were better than in the control group (P < 0.05). The prevalence of post-radiotherapy toxic side-effects was much lower in the observation group (11.84%) than in the control group (38.16%) (P < 0.05). Conclusion: The whole-course nutrition management could alleviate the side-effects of radiotherapy on the patients with abdominal tumor, possibly through improving the nutritional status and cellular immune function.

参考文献/References:


[1] 中华医学会放射肿瘤治疗学分会.放疗营养规范化管理专家共识.中华放射肿瘤学杂志,2020,29(5):324-331.
[2] Arends J, Baracos V, Bertz H, et al. ESPEN expert group recommendations for action against cancer-related malnutrition. Clin Nutr,2017,36(5):1187-1196.
[3] 花红霞,许勤,徐欣怡,等.人体组成评定在肿瘤患者营养评定中的研究进展.中国全科医学,2020,23(35):4519-4523,4529.
[4] 中国抗癌协会肿瘤营养与支持专业委员会肿瘤放疗营养学组.头颈部肿瘤放疗者营养与支持治疗专家共识.中华放射肿瘤学杂志,2018,27(1):1-6.
[5] 傅晓炜,滕丽华,沈金闻,等.直肠癌同步放化疗患者营养状态与放化疗不良反应相关性分析.中华放射肿瘤学杂志,2020,29(9):757-761.
[6] 隋婧婧,张洪明,王子国,等 . 全病程 MDT 营养管理对老年食管癌患者放疗进程的影响.中国肿瘤临床,2020,47(1):29-33.
[7] 李缨,钱红娟,黄芸,等.全程营养管理对肿瘤患者化疗前后营养变化的影响.中国医师进修杂志,2018,41(10):901-904.
[8] 张艳 . 全程营养管理对食管癌放疗患者营养状况影响 . 临床军医杂志,2019,47(6):586-588.
[9] Y?ld?z?eltek N,Süren M,Demir O,et al.Karnofsky Performance Scale validity and reliability of Turkish palliative cancer patients. Turk J Med Sci,2019,49(3):894-898.
[10] 黄菁,沈红梅,巫云立 . 加味养阴清肺汤联合营养干预对鼻咽癌放疗患者营养状态及疗效的影响.肿瘤防治研究,2019,46(2):159-163.
[11] Tang PL, Wang HH, Lin HS, et al. Body Composition Early Identifies Cancer Patients With Radiotherapy at Risk for Malnutrition.J Pain Symptom Manage,2018,55(3):864-871.
[12] Marshall KM,Loeliger J,Nolte L,et al.Prevalence of malnutrition and impact on clinical outcomes in cancer services: A comparison of two time points.Clin Nutr,2019,38(2):644-651.
[13] 张海霖,张含凤,江格非,等.全程营养管理对食管癌同步放化疗患者肠内营养干预的效果分析 . 重庆医学,2019,48(9):1594-1596.
[14] 王晓玲,武雪亮,孔令霞,等.全程精细化营养管理对进展期直肠癌短程放疗联合化疗患者营养状况、免疫功能及生活质量的影响. 重庆医学,2020,49(11):1769-1773.
[15] 吕佳,袁玲,卞丽娟,等.早期肠内营养支持对肝胆胰恶性肿瘤术后化疗患者营养状况、免疫功能及预后的影响. 中国临床研究, 2019,32(1):93-96.
[16] 陈英 . 宫颈癌同步放化疗患者接受营养干预前后免疫应答,毒副反应的变化. 海南医学院学报,2018,24(13):1280-1283.
[17] 王淑安,王孔成,李媛,等 . 放射性黏膜损伤的营养治疗策略 .中华放射肿瘤学杂志, 2019, 28(7):555-558.

相似文献/References:

[1]张力川,王玉洁,庄冰,等.三种营养不良诊断标准在头颈部恶性肿瘤放疗病人中的应用研究[J].肠外与肠内营养杂志,2021,(01):25.[doi:10.16151/j.1007-810x.2021.01.006]
 ZHANG Li-chuan,WANG Yu-jie,ZHUANG Bing,et al.Application of three diagnostic criteria of malnutrition in patients with head and neck cancer during radiotherapy[J].PARENTERAL & ENTERAL NUTRITION,2021,(04):25.[doi:10.16151/j.1007-810x.2021.01.006]

备注/Memo

备注/Memo:
基金项目 :南通市市级科技项目(MB2019021) 作者简介 :朱琪伟,副主任医师,医学硕士,从事乳腺及腹部肿瘤的放疗和综合治疗。E-mail:1623735892@qq.com 通讯作者 :王向前,E-mail:wangxiangqian01@126.com
更新日期/Last Update: 1900-01-01