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鼻胃管喂养可改善食管癌患者放化疗期间的营养状况和身体状况:一项回顾性研究。

Nasogastric tube feeding improves nutritional status and physical state in esophageal cancer patients during chemoradiotherapy: a retrospective study.

机构信息

Department of Clinic Nutrition, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, Jiangsu, China.

Department of Geriatric Medicine, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, Jiangsu, China.

出版信息

Support Care Cancer. 2023 May 17;31(6):341. doi: 10.1007/s00520-023-07780-w.

Abstract

OBJECTIVE

To compare the complication rates, nutritional status, and physical state between esophageal cancer (EC) patients managed by nasogastric tube (NGT) feeding versus those managed by oral nutritional supplementation (ONS) during chemoradiotherapy.

METHODS

EC patients undergoing chemoradiotherapy managed by nonintravenous nutritional support in our institute were retrospectively recruited and divided into an NGT group and an ONS group based on the nutritional support method. The main outcomes, including complications, nutritional status, and physical state, were compared between groups.

RESULTS

The baseline characteristics of EC patients were comparable. There were no significant differences in the incidence of treatment interruption (13.04% vs. 14.71%, P = 0.82), death (2.17% vs. 0.00%, P = 0.84), or esophageal fistula (2.17% vs. 1.47%, P = 1.00) between the NGT group and ONS group. Body weight loss and decrease in albumin level were significantly lower in the NGT group than in the ONS group (both P < 0.05). EC patients in the NGT group had significantly lower Nutritional Risk Screening 2002 (NRS2002) and Patient-Generated Subjective Global Assessment (PG-SGA) scores and significantly higher Karnofsky Performance Status (KPS) scores than patients in the ONS group (all P < 0.05). The rates of grade > 2 esophagitis (10.00% vs. 27.59%, P = 0.03) and grade > 2 bone marrow suppression (10.00% vs. 32.76%, P = 0.01) were significantly lower in the NGT group than in the ONS group. There were no significant differences in the incidence of infection and upper gastrointestinal disorders or therapeutic efficacy between groups (all P > 0.05).

CONCLUSIONS

EN through NGT feeding leads to significantly better nutritional status and physical state in EC patients during chemoradiotherapy than EN via ONS. NGT may also prevent myelosuppression and esophagitis..

摘要

目的

比较经鼻胃管(NGT)喂养与口服营养补充(ONS)在放化疗期间管理食管癌(EC)患者的并发症发生率、营养状况和身体状况。

方法

回顾性招募我院行放化疗并接受非静脉营养支持的 EC 患者,根据营养支持方式分为 NGT 组和 ONS 组。比较两组主要结局(并发症、营养状况和身体状况)。

结果

EC 患者的基线特征无显著差异。两组治疗中断发生率(13.04% vs. 14.71%,P=0.82)、死亡率(2.17% vs. 0.00%,P=0.84)或食管瘘发生率(2.17% vs. 1.47%,P=1.00)均无显著差异。NGT 组患者体重减轻和白蛋白水平下降明显低于 ONS 组(均 P<0.05)。NGT 组患者的营养风险筛查 2002(NRS2002)和患者主观整体评估(PG-SGA)评分明显低于 ONS 组,卡氏功能状态(KPS)评分明显高于 ONS 组(均 P<0.05)。NGT 组的 2 级以上食管炎发生率(10.00% vs. 27.59%,P=0.03)和 2 级以上骨髓抑制发生率(10.00% vs. 32.76%,P=0.01)明显低于 ONS 组。两组感染和上消化道疾病发生率或治疗效果差异均无统计学意义(均 P>0.05)。

结论

与 ONS 相比,EC 患者放化疗期间经 NGT 喂养可显著改善营养状况和身体状况。NGT 还可能预防骨髓抑制和食管炎。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0c6/10191914/f8d7629ada0b/520_2023_7780_Fig1_HTML.jpg

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