Peerawong Thanarpan, Phungrassami Temsak, Pruegsanusak Kovit, Sangthong Rassamee
Department of Radiology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
Asian Pac J Cancer Prev. 2012;13(11):5805-9. doi: 10.7314/apjcp.2012.13.11.5805.
The study aimed to compare treatment compliance and nutritional outcomes in nasopharyngeal carcinoma (NPC) patients during chemoradiation.
Clinical information of patients with NPC that underwent chemoradiation during 2004-2009 were retrieved from the hospital database and retrospectively reviewed. Patients were categorised into a prophylactic percutaneous endoscopic gastrostomy (PPEG) group and a non-PPEG group. Clinical information including treatment compliance, weight, haematological and renal toxicity was compared.
A total of 219 patients were reviewed and categorised into PPEG (n=77) and non-PPEG (n=142). Significant differences in absolute percentage weight loss between groups were found from the 3rd cycle of chemotherapy. There were 24.2, 20.3 and 24.8% in the third, the fourth and the fifth cycles of chemotherapy, respectively. Migration of grade 2 to grade 3 weight loss was obviously seen in the 3rd cycle as well. A significant difference of grade 3 or more hypokalemia was found with values of 14.3% and 50% in the PPEG and non-PPEG groups, respectively. Other toxicity parameters and treatment compliance were not different between the groups.
Use of PPEG resulted in decreased severe weight loss, reduced migration from grade 2 to grade 3 weight loss and reduced hypokalaemia. However, benefits in treatment compliance could not be detected. So consideration of PPEG in NPC patients requires care.
本研究旨在比较鼻咽癌(NPC)患者在放化疗期间的治疗依从性和营养状况。
从医院数据库中检索2004年至2009年期间接受放化疗的NPC患者的临床信息,并进行回顾性分析。患者被分为预防性经皮内镜下胃造口术(PPEG)组和非PPEG组。比较两组患者的治疗依从性、体重、血液学和肾脏毒性等临床信息。
共纳入219例患者,分为PPEG组(n = 77)和非PPEG组(n = 142)。从化疗第3周期开始,两组间绝对体重减轻百分比存在显著差异。化疗第3、4、5周期的绝对体重减轻百分比分别为24.2%、20.3%和24.8%。在第3周期,2级至3级体重减轻的迁移也很明显。PPEG组和非PPEG组3级及以上低钾血症的发生率分别为14.3%和50%,差异有统计学意义。两组间其他毒性参数和治疗依从性无差异。
使用PPEG可减少严重体重减轻,减少2级至3级体重减轻的迁移,并降低低钾血症的发生率。然而,未发现其对治疗依从性有改善作用。因此,在NPC患者中考虑使用PPEG时需谨慎。