Su Li, Lin Qiaojing, Li Rong, Hua Yangjingling, Zhang Hairong, Song Xiurong, Ye Jinru, Zhang Weijian, Hong Jinsheng
Department of Radiotherapy, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Key Laboratory of Radiation Biology Fujian Medical University, Fujian Province University, Fuzhou, China.
Head Neck. 2020 Dec;42(12):3580-3589. doi: 10.1002/hed.26426. Epub 2020 Aug 27.
To investigate nutritional impairment during intensity-modulated radiotherapy (IMRT) in patients with nasopharyngeal carcinoma (NPC) taking normal nutrition before IMRT and its effect on treatment-related toxicities (TRTs) and survival.
Modified nutrition index (m-NI) of 187 patients with NPC, comprised eight indicators (body mass index, circumference of upper arm muscles, total lymphocyte count, red blood cell count, levels of albumin, pre-albumin, transferrin, and hemoglobin), were evaluated before/after IMRT. Patient characteristics, m-NI, and the follow-up data for survival and TRTs were analyzed.
The m-NI scores of patients with NPC decreased significantly after IMRT. Severe nutritional impairment (SNI; decrease in m-NI score ≥50%) was an independent prognostic factor for overall survival (OS) and an independent risk factor for grade ≥2 oral mucositis. Classification T4 disease and smoking were SNI risk factors.
SNI during IMRT is a risk factor for oral mucositis and a prognostic factor for worse OS in patients with NPC.
探讨在调强放射治疗（IMRT）期间，鼻咽癌（NPC）患者在IMRT前营养正常时的营养损害情况及其对治疗相关毒性（TRTs）和生存的影响。
对187例NPC患者的改良营养指数（m-NI）进行评估，该指数包括八项指标（体重指数、上臂肌肉周长、总淋巴细胞计数、红细胞计数、白蛋白水平、前白蛋白、转铁蛋白和血红蛋白），分别在IMRT前后进行评估。分析患者特征、m-NI以及生存和TRTs的随访数据。
NPC患者的m-NI评分在IMRT后显著降低。严重营养损害（SNI；m-NI评分降低≥50%）是总生存（OS）的独立预后因素，也是≥2级口腔黏膜炎的独立危险因素。T4期疾病和吸烟是SNI的危险因素。
IMRT期间的SNI是NPC患者口腔黏膜炎的危险因素和OS较差的预后因素。
