Role of intensive nutrition support and prophylactic percutaneous endoscopic gastrostomy during concomitant chemoradiotherapy for oropharyngeal cancer
Role of intensive nutrition support and prophylactic percutaneous endoscopic gastrostomy during concomitant chemoradiotherapy for oropharyngeal cancer
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强化营养支持和预防性经皮内镜胃造口术在口咽癌同步放化疗中的作用
DOI：
10.1007/s10147-018-1328-x
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发表时间：
2018
影响因子：
3.3
通讯作者：
Nibu Ken-ichi
中科院分区：
文献类型：
--
作者：
Takahashi Miki;Kosaka Nana;Wakui Emi;Iwaki Shinobu;Nishii Mika;Teshima Masanori;Shinomiya Hirotaka;Morimoto Koichi;Kiyota Naomi;Sasaki Ryohei;Usami Makoto;Otsuki Naoki;Nibu Ken-ichi
背景同步放化疗（CCRT）会导致严重的粘膜炎和吞咽功能障碍，常常导致营养不良。据报道，除经皮内窥镜胃造口术 (PEG) 外，强化营养支持 (INS) 可减少 CCRT 期间的不良反应。患者和方法对接受基于 CDDP 的 CCRT 治疗的 58 例口咽癌患者进行回顾性分析。将 29 例联合 PEG 治疗的患者分为 INS 组，另外 29 例联合 PEG 治疗但未联合 INS 的患者分为对照组。 结果 INS 联合 PEG 显着增加了 CCRT 后半程的热量摄入，并减少了粘膜炎 (p= 0.0019)、白细胞减少 (p= 0.04) 和肾功能等不良事件。 （p= 0.006）。此外，29 名患者中有 21 名成功施用了 200 mg/m2 或更多的 CDDP，而对照组中 29 名患者中只有 10 名获得了足够量的 CDDP。结论这些结果表明，除了预防性 PEG 之外，INS 不仅可以减少不良反应，还可能改善 CCRT 治疗的口咽癌患者的肿瘤学结果。
BackgroundConcomitant chemoradiotherapy (CCRT) produces severe mucositis and swallowing dysfunction, often resulting in malnutrition. Intensive nutrition support (INS) in addition to percutaneous endoscopic gastrostomy (PEG) is reported to decrease adverse effects during CCRT.Patients and MethodsFifty-eight patients with oropharyngeal cancer treated by CDDP-based CCRT were retrospectively analyzed. Twenty-nine patients treated with INS in addition to PEG were classified as INS group, and other 29 patients treated with PEG but without INS were classified as control group.ResultsINS in addition to PEG significantly increased calorie intake in the second half of CCRT and reduced adverse events including mucositis (p= 0.0019), leukopenia (p= 0.04), and renal function (p= 0.006). Moreover, 21 out of 29 patients had successfully administration of 200 mg/m2 or more of CDDP, while only 10 out of 29 patients had enough amount of CDDP in control group.ConclusionsThese results suggest that INS in addition to prophylactic PEG not only decreases adverse effects but also may potentially improve oncological outcome of the patients with oropharyngeal cancer treated by CCRT.