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鼻咽癌患者在放化疗期间行与不行经皮内镜下胃造口术的治疗依从性和营养结局比较

Comparison of treatment compliance and nutritional outcomes among patients with nasopharyngeal carcinoma with and without percutaneous endoscopic gastrostomy during chemoradiation.

作者信息

Peerawong Thanarpan, Phungrassami Temsak, Pruegsanusak Kovit, Sangthong Rassamee

机构信息

Department of Radiology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.

出版信息

Asian Pac J Cancer Prev. 2012;13(11):5805-9. doi: 10.7314/apjcp.2012.13.11.5805.

Abstract

AIMS

The study aimed to compare treatment compliance and nutritional outcomes in nasopharyngeal carcinoma (NPC) patients during chemoradiation.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

摘要

目的

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。

方法

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。

结果

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。

结论

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。

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