家庭肠内营养可预防同期放化疗治疗鼻咽癌患者的骨髓抑制。
Home enteral nutrition may prevent myelosuppression of patients with nasopharyngeal carcinoma treated by concurrent chemoradiotherapy.
机构信息
Department of Clinical Nutrition, West China Hospital, Sichuan University, Chengdu, China.
Department of Radiotherapy, West China Hospital, Sichuan University, Chengdu, China.
出版信息
Head Neck. 2019 Oct;41(10):3525-3534. doi: 10.1002/hed.25861. Epub 2019 Jul 12.
BACKGROUND
The aim of this study is to assess the effect of home enteral nutrition (HEN) on the myelosuppression of patients with nasopharyngeal cancer (NPC) during the course of concurrent chemoradiotherapy (CCRT).
METHODS
A total of 18 outpatients with NPC administered oral nutritional supplementation intervention at home during the course of CCRT were designated as the HEN group, whereas 36 patients with NPC who had previously completed CCRT were retrospectively included as the control group. Patient Generated Subjective Global Assessment, body mass index (BMI), and blood test were evaluated prior to CCRT. During the course of CCRT, blood test was assessed every 2 weeks.
RESULTS
In male patients, hemoglobin (HB) and red blood cell were decreased (P < .05) in both HEN and control group after CCRT, whereas white blood cell (WBC) started to decrease since week 2 of CCRT in the control group but maintained in the HEN group which was significantly higher than the control (5.05 ± 1.29 vs 3.77 ± 1.5, P < .05). In female patients, HB and WBC were reduced in control group during CCRT, whereas these indicators also maintained in the HEN group. Surprisingly, all patients with lower BMI (<24 kg/m ) had a significant increase in platelet (PLT) after CCRT (200.78 ± 58.03 vs 253.00 ± 69.82, P < .05), while had steady HB and WBC values in the HEN group. At the end of CCRT, WBC and PLT of the HEN group were both higher than those in the control group (5.21 ± 1.07 vs 3.37 ± 1.52), (253.00 ± 69.82 vs 165.57 ± 59.56) (P < .05 for both). Our findings suggest that HEN is effective in preventing myelosuppression during CCRT for patients with NPC.
CONCLUSION
Our findings suggest that HEN is effective in preventing myelosuppression during CCRT for patients with NPC.
背景
本研究旨在评估家庭肠内营养（HEN）对同期放化疗（CCRT）期间鼻咽癌（NPC）患者骨髓抑制的影响。
方法
共纳入 18 例 NPC 门诊患者，在 CCRT 期间接受家庭口服营养补充干预，将其设为 HEN 组，同时回顾性纳入 36 例已完成 CCRT 的 NPC 患者作为对照组。在 CCRT 前评估患者的患者主观整体评估（PG-SGA）、体重指数（BMI）和血液检查。在 CCRT 期间，每 2 周评估一次血液检查。
结果
在男性患者中，CCRT 后 HEN 组和对照组的血红蛋白（HB）和红细胞均下降（P<0.05），而对照组的白细胞（WBC）从 CCRT 第 2 周开始下降，但在 HEN 组中保持不变，明显高于对照组（5.05±1.29 比 3.77±1.5，P<0.05）。在女性患者中，CCRT 期间对照组 HB 和 WBC 下降，而 HEN 组这些指标保持不变。令人惊讶的是，所有 BMI<24kg/m2 的患者在 CCRT 后血小板（PLT）显著增加（200.78±58.03 比 253.00±69.82，P<0.05），而 HEN 组 HB 和 WBC 值保持稳定。在 CCRT 结束时，HEN 组的 WBC 和 PLT 均高于对照组（5.21±1.07 比 3.37±1.52），（253.00±69.82 比 165.57±59.56）（均 P<0.05）。我们的研究结果表明，HEN 可有效预防 NPC 患者 CCRT 期间的骨髓抑制。
结论
我们的研究结果表明，HEN 可有效预防 NPC 患者 CCRT 期间的骨髓抑制。
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