Perioperative arginine-supplemented nutrition in malnourished patients with head and neck cancer improves long-term survival
Perioperative arginine-supplemented nutrition in malnourished patients with head and neck cancer improves long-term survival
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DOI：
10.3945/ajcn.2010.29532
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发表时间：
2010-11-01
影响因子：
7.1
通讯作者：
van Leeuwen, Paul A. M.
中科院分区：
文献类型：
--
作者：
Buijs, Nikki;van Bokhorst de van der Schueren, Marian A. E.;van Leeuwen, Paul A. M.
背景：癌症患者的血浆精氨酸浓度较低，这表明这些患者的精氨酸代谢可能受到干扰。补充精氨酸与抗肿瘤机制的积极作用有关，并已显示出减少肿瘤生长和延长生存期。此外，头颈癌患者的预后仍然令人失望，摄入不足经常导致营养不良，这导致高血压。发病率和死亡率目的本研究的目的是评估围手术期补充精氨酸对严重营养不良的头颈部肿瘤患者的长期影响。设计在本双盲随机试验中，对照试验我们将32名严重营养不良的头颈部癌症患者随机分为两组，1组接受标准围手术期肠内营养（n = 15），2组接受标准围手术期肠内营养（n = 15），精氨酸补充围手术期肠内营养（n = 17）主要结局是长期（≥ 10年）生存，次要结局包括局部复发、远处转移和第二原发肿瘤的长期表现。丰富的营养比患病的生存率要高得多。（P = 0019）和更好的疾病特异性生存补充精氨酸组的局部无复发生存率明显高于对照组（P = 0022）结论围手术期应用精氨酸强化肠内营养可显著提高患者的长期生存率和远期生存率，营养不良的头颈癌患者的长期疾病特异性生存率美国临床营养杂志2010 92 1151-6
Background Plasma arginine concentrations are lower in patients with cancer which indicates that arginine metabolism may be disturbed in these patients A ginine supplementation has been associated with positive effects on antitumor mechanisms and has been shown to reduce tumor growth and to prolong survival Furthermore the prognosis of patients with head and neck cancer remains disappointing Insufficient intake frequently leads to malnutrition which contributes to high morbidity and mortality ratesObjective The aim of this study was to assess the long term effects of perioperative arginine supplementation in severely malnourished patients with head and neck cancelDesign In this double blind randomized, controlled trial we randomly assigned 32 severely malnourished patients with head and neck cancer to receive 1) standard perioperative enteral nutrition (n = 15) or 2) arginine supplemented perioperative enteral nutrition (n = 17) The primary outcome was long term (>= 10 y) survival Secondary outcomes included the long term appearance of locoregional recurrence distant metastases and second primary tumorsResults No significant differences in baseline characteristics were observed between groups The group Teeming arginine-enriched nutrition h id a significantly better over ill survival (P = 0 019) and better disease specific survival (P = 0 022) Furthermore the arginine supplemented group had significantly better locoregional recurrence free survival (P = 0 027) No significant difference in the occurrence of distant metastases or occurrence of a second primary tumor was observed between the groupsConclusion Perioperative arginine enriched enteral nutrition significantly improved the long-term overall survival and long-term disease specific survival in malnourished patients with held and neck cancer Am J Clin Nutr 2010 92 1151-6