胃癌术后辅助放化疗毒副反应与患者营养状况的相关性研究

Correlation between nutritional status of patients with adjuvant chemoradiotherapy after gastric cancer surgery and side effects

  • 摘要: 目的 探讨胃癌术后辅助放化疗患者的营养状况及其与放化疗毒副反应的相关性。 方法 选取2015年10月—2018年10月本院收治的经手术治疗后行辅助放化疗的患者88例,根据营养风险筛查量表(NRS2002)评分将患者分为营养正常组(n=42)与营养风险组(n=46)。记录2组放化疗期间骨髓抑制、神经系统、血液系统、胃肠道等毒副反应发生情况,并参照世界卫生组织(WHO)化疗不良反应分级标准对毒副反应进行分级,并分析患者营养状况与放化疗毒副反应的相关性。 结果 营养风险组骨髓抑制、神经系统、血液系统、胃肠道等毒副反应发生率均较营养正常组高,差异有统计学意义(P<0.05)。Spearman相关性分析显示,营养状况与骨髓抑制(r=-0.527, P=0.001)、神经系统(r=-0.352, P=0.001)、血液系统(r=-0.430, P=0.001)、胃肠道(r=-0.380, P=0.001)等毒副反应发生率呈显著负相关。 结论 营养不良状况可增大胃癌术后辅助放化疗的毒副反应发生风险,影响患者后续治疗耐受性,化疗期间需加强对患者的营养干预。

     

    Abstract: Objective To investigate the nutritional status of patients with adjuvant chemoradiotherapy after gastric cancer surgery and its correlation with side effects of chemoradiotherapy. Methods Totally 88 patients with adjuvant chemoradiotherapy after gastric cancer surgery from October 2015 to October 2018 in our hospitals were selected and divided into normal nutrition group(n=42)and risk nutritional group(n=46)according to the score of Nutritional Risk Scale(NRS2002). The adverse reactions such as myelosuppression, side effects of nervous system, blood system and gastrointestinal tract were recorded during radiotherapy and chemotherapy in both groups, and the adverse reactions were classified according to the World Health Organization(WHO)classification standard of chemotherapy related adverse reactions, and the correlation between the nutritional status of patients and the adverse reactions of chemoradiotherapy was analyzed. Results The incidence rates of myelosuppression, side effects of nervous system, blood system and gastrointestinal tract in the risk nutrition group were significantly higher than those in the normal nutrition group(P<0.05). Spearman's correlation analysis showed that nutritional status was negatively correlated with myelosuppression(r=-0.527, P=0.001), nervous system(r=-0.352, P=0.001), blood system(r=-0.430, P=0.001)and gastrointestinal tract(r=-0.380, P=0.001). Conclusion Malnutrition can increase the risk of side effects of postoperative adjuvant radiotherapy and chemotherapy for gastric cancer - and affect the patient's tolerance of follow-up treatment. Therefore, nutritional intervention should be strengthened during chemotherapy.

     

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