个体化营养干预对局部晚期鼻咽癌患者生活质量及生存预后的影响

doi:10.19401/j.cnki.1007-3639.2021.12.008

中国癌症杂志 ›› 2021, Vol. 31 ›› Issue (12): 1202-1208.doi: 10.19401/j.cnki.1007-3639.2021.12.008

个体化营养干预对局部晚期鼻咽癌患者生活质量及生存预后的影响

卢大松，冯勇军，王武峰，牟忠林，赵　娜

海南医学院第二附属医院耳鼻咽喉头颈外科，海南海口 570311

出版日期:2021-12-30 发布日期:2022-01-07
通信作者: 卢大松 E-mail: lds0343@126.com
基金资助:
海南省卫生健康行业科研项目（20A200337）。

Influence of individualized nutrition intervention on quality of life and survival prognosis of patients with locally advanced nasopharyngeal carcinoma

LU Dasong, FENG Yongjun, WANG Wufeng, MOU Zhonglin, ZHAO Na

Department of Otolaryngology, the Second Affiliated Hospital of Hainan Medical College, Haikou 570311, Hainan Province, China

Published:2021-12-30 Online:2022-01-07
Contact: LU Dasong E-mail: lds0343@126.com

摘要/Abstract

摘要： 背景与目的：同步放化疗是局部晚期鼻咽癌的首选治疗方法，但放化疗会使患者营养状况持续恶化，进而影响患者的生活质量及生存预后。探讨基于营养风险评估的个体化营养干预对局部晚期鼻咽癌同步放化疗患者生活质量及生存预后的影响。方法：选取2017年1月—2019年3月海南医学院第二附属医院耳鼻咽喉头颈外科收治的局部晚期鼻咽癌患者116例，随机分为干预组和对照组，每组58例，所有患者均接受同步放化疗，对照组放化疗期间行常规饮食指导，干预组患者根据营养风险评估行个体化营养干预。比较两组患者的营养状况变化、生活质量，并分析两组患者的2年和3年总生存率（overall survival，OS），无局部复发生存率（local recurrence-free survival，LRFS），无远处转移生存率（distant metastasis- free survival，DMFS）。结果：干预组放疗2周、放疗4周及放疗结束时营养不良发生率分别为27.59%、46.55%和51.72%，均低于对照组的48.28%、75.86%和81.03%，差异有统计学意义（P ＜ 0.05）。治疗后干预组躯体功能、角色功能、认知功能、情绪功能、社会功能等生活质量评分均高于对照组，差异有统计学意义（P ＜ 0.05）。干预组2年和3年OS、LRFS、DMFS均高于对照组，差异有统计学意义（P ＜ 0.05）。结论：个体化营养干预能有效地改善局部晚期鼻咽癌患者放化疗期间的营养状况，提高患者生活质量，改善生存预后。

关键词: 鼻咽癌, 局部晚期, 营养干预, 同步放化疗, 生活质量, 生存预后

Abstract: Background and purpose: Concurrent chemoradiotherapy is the preferred treatment for locally advanced nasopharyngeal carcinoma. However, concurrent chemoradiotherapy will worsen the nutritional status of patients, thus affecting the quality of life and survival prognosis of patients. This study aimed to investigate the effect of individualized nutritional intervention based on nutritional risk assessment on quality of life and survival prognosis of patients with locally advanced nasopharyngeal carcinoma undergoing concurrent chemoradiotherapy. Methods: A total of 116 patients with locally advanced nasopharyngeal carcinoma treated in the Second Affiliated Hospital of Hainan Medical College from January 2017 to March 2019 were enrolled and randomly divided into the intervention group (58 cases) and the control group (58 cases). The patients in both groups were treated with the same concurrent chemoradiotherapy. The control group received routine dietary guidance, and the intervention group received individualized nutritional intervention based on nutritional risk assessment during concurrent chemoradiotherapy. The nutritional status and life quality of the two groups were compared, and the 2-year and 3-year overall survival (OS), local recurrence-free survival (LRFS) and distant metastasis-free survival (DMFS) of the two groups were analyzed. Results: The incidence of malnutrition in the intervention group at 2 weeks, 4 weeks and the end of radiotherapy was 27.59%, 46.55% and 51.72% respectively, which were lower than 48.28%, 75.86% and 81.03% of the control group (P ＜ 0.05). After treatment, scores of life quality including psychological function, role function, cognitive function, emotional function, social function were significantly higher in the intervention group than in the control group (P ＜ 0.05). The 2-year and 3-year OS, LRFS and DMFS were higher in the intervention group than in the control group (P ＜ 0.05). Conclusion: Individualized nutrition intervention can effectively improve the nutritional status, life quality and the survival prognosis of locally advanced nasopharyngeal carcinoma patients during concurrent chemoradiotherapy.

Key words: Nasopharyngeal carcinoma, Locally advanced, Nutrition intervention, Concurrent chemoradiotherapy, Life quality, Survival prognosis

卢大松, 冯勇军, 王武峰, 牟忠林, 赵　娜. 个体化营养干预对局部晚期鼻咽癌患者生活质量及生存预后的影响[J]. 中国癌症杂志, 2021, 31(12): 1202-1208.

LU Dasong, FENG Yongjun, WANG Wufeng, MOU Zhonglin, ZHAO Na . Influence of individualized nutrition intervention on quality of life and survival prognosis of patients with locally advanced nasopharyngeal carcinoma[J]. China Oncology, 2021, 31(12): 1202-1208.

[1]	林艺, 王策, 康勋, 康庄, 陈峰, 江波, 李文斌. 胶质母细胞瘤复发相关基因的筛选、表达和临床预后分析[J]. 中国癌症杂志, 2022, 32(1): 13-23.
[2]	蒋朝阳, 王　娟, 张　伶, 高　辉, 张　涛, 李智慧 . 709例鼻咽癌颈部各区淋巴结转移的相关性分析[J]. 中国癌症杂志, 2021, 31(7): 629-634.
[3]	吴婧文, 于学娟, 杨秋安. 小野寺预后营养指数与食管鳞癌同步放化疗不良反应的相关性研究[J]. 中国癌症杂志, 2020, 30(7): 525-530.
[4]	沈　洁, 莫　淼, 袁　晶, 周昌明, 王泽洲, 张志红, 温　灏, 吴小华, 郑　莹 . 1 313例局部晚期宫颈癌患者的长期生存报告：以医院为基础的真实世界研究[J]. 中国癌症杂志, 2020, 30(3): 192-198.
[5]	杨?青，区晓敏，胡超苏. 血小板-淋巴细胞比值在鼻咽癌预后预测中的作用：Meta分析[J]. 中国癌症杂志, 2019, 29(8): 576-582.
[6]	李文成，王孝深. 铂类药物在头颈部鳞癌治疗中的选择与应用[J]. 中国癌症杂志, 2019, 29(4): 300-306.
[7]	汪宇洁，吕涛，王孝深. CRISPR-Cas9敲除Notch1对CNE2细胞增殖及辐射敏感性的影响[J]. 中国癌症杂志, 2019, 29(2): 111-118.
[8]	黄　娟,陈晓慧,翟瑞萍,等. 鼻咽癌调强放射治疗设置头颈前部淋巴引流保护区的剂量学可行性研究[J]. 中国癌症杂志, 2018, 28(9): 692-697.
[9]	郑营营,徐俊彦,张建平,等. ¹⁸F-FDG PET/CT纹理分析预测局部晚期直肠癌新辅助放化疗疗效的价值[J]. 中国癌症杂志, 2018, 28(8): 590-594.
[10]	杨佑琦,区晓敏,周　鑫,等. GP、PF及TPF方案化疗联合调强适形放疗治疗鼻咽癌的临床疗效[J]. 中国癌症杂志, 2018, 28(8): 602-608.
[11]	吴　刚,王　奋,林少民,等. 磁共振扩散峰度成像预测鼻咽癌放疗近期疗效研究[J]. 中国癌症杂志, 2018, 28(5): 369-375.
[12]	张　萍,虞维博,许　青,等. 探究体质量指数对鼻咽癌患者放疗摆位误差的影响[J]. 中国癌症杂志, 2018, 28(5): 389-393.
[13]	刘晓文,龙子雯,蔡　宏,等. 局部进展期胃癌术前化疗与术前放化疗的对比研究[J]. 中国癌症杂志, 2018, 28(10): 762-768.
[14]	丁慧萍,窦圣金,汪　琼,等. 口服营养补充对鼻咽癌同期放化疗患者的影响[J]. 中国癌症杂志, 2018, 28(1): 62-68.
[15]	韩立涛,渠　宁,史荣亮,等. 鼻咽癌放化疗后颈部淋巴结残留及复发的外科治疗综述[J]. 中国癌症杂志, 2017, 27(6): 505-509.

个体化营养干预对局部晚期鼻咽癌患者生活质量及生存预后的影响

Influence of individualized nutrition intervention on quality of life and survival prognosis of patients with locally advanced nasopharyngeal carcinoma

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价