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营养支持对不可切除的局部晚期食管鳞状细胞癌短期临床结局及免疫反应的影响

Effects of nutritional support on short-term clinical outcomes and immune response in unresectable locally advanced oesophageal squamous cell carcinoma.

作者信息

Chen F, Fang J, Wang H, Song T, Zhu W, Wu M, Wu Y

机构信息

Department of Nursing, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China.

出版信息

Eur J Cancer Care (Engl). 2018 Mar;27(2):e12818. doi: 10.1111/ecc.12818. Epub 2018 Jan 18.

Abstract

This retrospective study investigated the efficiency of nutritional support in unresectable locally advanced oesophageal squamous cell carcinoma (LAOSCC) patients who received concurrent chemoradiotherapy (CCRT) based on 5-fluorouracil and cisplatin. In the routine care group, 63 patients served as historical controls and received nutrition support in a reactive manner. In addition, 57 patients in the nutritional support group received timely diet counselling, oral nutritional supplements, enteral nutrition and/or parenteral nutrition during CCRT. This support was based on scores from nutritional risk screening 2002 (NRS-2002) after June 2014. The nutritional support group had significant advantages over the routine care group with respect to the incidence of neutropenia, the objective response rate, the change in serum albumin and the lengths of hospital stay. In addition, the nutritional support group had significantly higher levels of IgG and IL-2, higher proportions of NK, CD3 and CD4 cells as well as a higher ratio of CD4 /CD8 cells than the routine care group (p < .05). In contrast, the nutritional support group had a significantly lower level of IL-6. In conclusion, the current nutritional care programme could bring benefits of improving treatment compliance, reducing toxicity and lengths of hospital stay and enhancing the immune response.

摘要

这项回顾性研究调查了接受基于5-氟尿嘧啶和顺铂的同步放化疗(CCRT)的不可切除局部晚期食管鳞状细胞癌(LAOSCC)患者营养支持的效果。在常规护理组中,63例患者作为历史对照,以反应性方式接受营养支持。此外,营养支持组的57例患者在CCRT期间接受了及时的饮食咨询、口服营养补充剂、肠内营养和/或肠外营养。这种支持基于2014年6月后营养风险筛查2002(NRS-2002)的评分。营养支持组在中性粒细胞减少症发生率、客观缓解率、血清白蛋白变化和住院时间方面比常规护理组具有显著优势。此外,营养支持组的IgG和IL-2水平显著更高,NK、CD3和CD4细胞比例更高,CD4/CD8细胞比值也高于常规护理组(p<0.05)。相比之下,营养支持组的IL-6水平显著更低。总之,当前的营养护理方案可以带来改善治疗依从性、降低毒性和住院时间以及增强免疫反应的益处。

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