全程营养支持治疗对宫颈癌患者急性放射反应、耐受性和疗效影响的临床观察#br#
#br#

摘要/Abstract

摘要： 目的探讨全程营养支持治疗对宫颈癌患者急性放射反应、治疗耐受性和疗效的影响。
方法将经营养风险筛查2002（NRS2002）且评分≥3分的98例行根治性同步放化疗的局部晚期宫颈癌患者随机分成实验组（全程营养支持治疗+同步放化疗）46例和对照组（同步放化疗）52例。记录放疗前、后的体质量指数（BMI）、白蛋白（ALB）、前白蛋白（PA）及生活质量评分（KPS评分），并在放疗结束时对两组患者急性放射反应、治疗耐受性（放疗总疗程、放疗中断率、化疗完成次数）和疗效进行评价。
结果实验组均按计划完成治疗，仅13例曾经出现放疗中断；对照组52例中有45例曾经出现放疗中断，其中9例未能按计划完成放疗。实验组放疗中断率低于对照组（2826％ vs. 8654％），实验组化疗完成次数多于对照组（496±021 vs. 431±073），实验组放疗总天数低于对照组（6313±647 vs.8523±1928），差异均有统计学意义（P＜005）。实验组放疗后ALB 、PA均优于对照组（P＜005）。实验组急性放射性直肠炎、急性胃肠道反应及骨髓抑制的发生率与发生程度均低于对照组（P＜005）。实验组患者的总有效率（RR）明显高于对照组（9348％ vs. 7442％），差异均有统计学意义（P＜005）。
结论全程营养支持治疗能显著降低宫颈癌根治性同步放化疗患者急性放射反应，改善患者营养状况和生活质量，提高治疗耐受性和放疗疗效。

关键词: 宫颈癌, 营养, 放射治疗, 耐受性, 疗效

Abstract: ObjectiveTo investigate the effect of whole course nutritional support on acute radiation response， treatment tolerance and curative effect of cervical cancer patients.
MethodsNinetyeight locally advanced cervical patients with radical concurrent chemoradiotherapy and nutritional risk screening2002 scoring more than 3 points were divided randomly into two groups： 46 cases in the experimental group （used whole course nutritional support combined concurrent chemoradiotherapy） and 52 cases in the control group （only concurrent chemoradiotherapy）. The body mass index （BMI）， albumin （ALB）， prealbumin （PA） and quality of life score （KPS score） were recorded before and after radiotherapy， and the acute radioactivity， treatment tolerance （the total course of radiotherapy， the interruption rate of radiotherapy， the number of chemotherapy） and the curative effect were evaluated at the end of the radiotherapy.
ResultsIn the experimental group， the treatment was completed according to the plan， only 13 cases had been interrupted by radiotherapy， and 45 of the 52 cases in the control group had been treated with radiotherapy interruption， of which 9 cases failed to complete the radiotherapy according to the plan. The rate of radiotherapy in the experimental group was lower than that of the control group （2826％ vs. 8654％）， and the number of chemotherapy in the experimental group was more than that of the control group （496 ± 021 vs. 431 ± 073）. The total day of radiotherapy in the experimental group was lower than that of the control group （6313 ± 647 vs. 8523 ± 1928）， and the difference was statistically significant （P＜005）. The ALB and PA of the experimental group were better than those of the control group after radiotherapy （P＜005）. The incidence and incidence of acute radiation proctitis， acute gastrointestinal reaction and myelosuppression in the experimental group were lower than those in the control group （P＜005）. The total effective rate （RR） of the experimental group was significantly higher than that of the control group （9348％ vs. 7442％）， and the difference was statistically significant （P＜005）.
ConclusionTotal nutritional support can significantly reduce the acute radiation reaction in patients with radical cervical cancer， improve the patients nutritional status and quality of life， and improve the therapeutic tolerance and radiotherapy effect.

Key words: Cervical Cancer, Nutrition, Radiotherapy, Tolerance, Efficacy

于娇, 喻凤曹席明. 全程营养支持治疗对宫颈癌患者急性放射反应、耐受性和疗效影响的临床观察#br# #br#[J]. 临床肿瘤学杂志, 2018, 23(7): 635-639.

YU Jiao, YU Feng, CAO Ximing. . Clinical observation on the effect of whole course nutritional support on acute radiation response， tolerance and curative effect of cervical cancer patients#br#[J]. Chinese Clinical Oncology, 2018, 23(7): 635-639.

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