The use of percutaneous endoscopic gastrostomy in advanced nasopharyngeal carcinoma

许昀; 林锦; 韩露; 郭巧娟; 张伟; 黄贺; 李睿; 林少俊; 潘建基

doi:10.3969/j.issn.1007-3969.2013.12.010

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The use of percutaneous endoscopic gastrostomy in advanced nasopharyngeal carcinoma

更新时间：2025-12-31

- The use of percutaneous endoscopic gastrostomy in advanced nasopharyngeal carcinoma
- China Oncology Vol. 23, Issue 12, Pages: 989-994(2013)
- 作者机构：
  
  福建医科大学教学医院，福建省肿瘤医院放疗科,福州,350014
- 作者简介：
- 基金信息：
- DOI：10.3969/j.issn.1007-3969.2013.12.010
  CLC：
- Published Online：17 February 2014，
  
  Published：17 February 2013
- 稿件说明：
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许昀,林锦,韩露,郭巧娟,张伟,黄贺,李睿,林少俊,潘建基. 经皮内镜下胃造瘘术在进展期鼻咽癌中的应用[J]. 中国癌症杂志, 2013, 23(12): 989-994.

许昀, 林锦, 韩露, et al. The use of percutaneous endoscopic gastrostomy in advanced nasopharyngeal carcinoma[J]. China Oncology, 2013, 23(12): 989-994.
许昀,林锦,韩露,郭巧娟,张伟,黄贺,李睿,林少俊,潘建基. 经皮内镜下胃造瘘术在进展期鼻咽癌中的应用[J]. 中国癌症杂志, 2013, 23(12): 989-994. DOI： 10.3969/j.issn.1007-3969.2013.12.010.

许昀, 林锦, 韩露, et al. The use of percutaneous endoscopic gastrostomy in advanced nasopharyngeal carcinoma[J]. China Oncology, 2013, 23(12): 989-994. DOI： 10.3969/j.issn.1007-3969.2013.12.010.

摘要

背景与目的：鼻咽癌好发于我国南方地区，同步放化疗在进展期鼻咽癌中的疗效显著，但同步放化疗的不良反应较单纯放疗显著增加，影响了患者放化疗的顺利进行。目前临床上常用局部对症处理和全身营养支持治疗等方法减轻放疗反应以提高患者治疗耐受性，但收效甚微。本文旨在探讨经皮内镜下胃造瘘术(percutaneous endoscopic gastrostomy，PEG)在进展期鼻咽癌中的应用价值。方法：福建省肿瘤医院2010年10月—2012年6月71例病理证实的初诊鼻咽癌进展期患者，放化疗前行PEG术，放化疗期间行胃造瘘饮食及相关护理，检测放化疗不良反应、治疗耐受性及体重、血清白蛋白等营养指标情况。结果：71例患者行PEG术68例成功，3例失败。剩下的64例患者中51例顺利完成3周方案的同步化疗，同步化疗完成率为79.69%，4例因肝转移或肝功能损害未行同步化疗。所有68例患者体重变化在-11.86%~0.83%内，平均-5.32%±2.99%，前后血清白蛋白配对t检验提示放化疗前后差异无统计学意义(P=0.742)。60.29%(41/68)患者发生Ⅱ度放射性口腔炎，22.06%(15/68)患者发生Ⅲ度放射性口腔炎。结论：对初诊进展期鼻咽癌患者行预防性PEG术提高了患者同步放化疗的耐受性，降低了不良反应，减少了因放化疗不良反应引起的放疗中断时间，提高了同步化疗的完成率，改善了患者的营养状况及生存质量，且简单、经济、易行、安全。

Abstract

Background and purpose: Nasopharyngeal carcinoma usually occurs in people of states of the Southern China. Chemoradiotherapy plays an important role in the therapy of advanced nasopharyngeal carcinoma. However

chemoradiotherapy causes more toxic side effects than radiation therapy alone

which affects the therapy. Now symptomatic treatment and nutrition supports are common ways in the clinic in order to improve the tolerance of patients for the therapy

but with little effect. To evaluate the clinical significance of percutaneous endoscopic gastrostomy (PEG) in advanced nasopharyngeal carcinoma. Methods: From Oct. 2010 to Jun. 2012

a total of 71 patients with advanced nasopharyngeal carcinoma who received PEG before chemoradiotherapy were enrolled. During chemoradiotherapy

gastrostomy diet and nursing were supplied

adverse events

tolerance and nutrition indicators including weight and alcohol of human albumin were detected as well. Results: PEG were performed successfully on 68 patients

but failed in the other 3 patients. Of the 68 patients

4 have not received concurrent chemotherapy because of liver metastases and liver function damage

51 of the remaining 64 patients could completely finished 3 cycles of concurrent chemotherapy

with the completion rate of concurrent chemotherapy at 79.69%. The weight change ranged from -11.86% to 0.83%

with a mean value of -5.32%±2.99%. Paired-sample t test of human albumin before and after the treatment showed no significant difference (P=0.742). Grade Ⅱ radioactive oral cavity mucositis appeared in 60.29% patients (41/68)

and 22.06% patients (15/68) suffered grade Ⅲ radioactive oral cavity mucositis.Conclusion: For patients with advanced nasopharyngeal carcinoma

preventative PEG improved the tolerance of chemoradiotherapy

reduce the incidence of adverse events. The period of therapy interruption caused by sever adverse event were shortened as well

PEG also increased the completion rate of concurrent chemotherapy. Nutritional status and living quality of patients are improved. In addition

PEG is a safe

economic and simple method.

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