同步放化疗联合早期综合营养治疗在局部晚期鼻咽癌中的应用价值

Application value of concurrent chemoradiotherapy combined with early comprehensive nutritional therapy in patients with locally advanced nasopharyngeal carcinoma

摘要:

目的 探讨同步放化疗联合早期综合营养治疗在局部晚期鼻咽癌中的应用价值。方法 回顾性分析2018年1月—2020年12月在河南省肿瘤医院就诊的100例局部晚期鼻咽癌患者，根据不同干预方式分为对照组和观察组，每组50例。对照组同步放化疗和常规营养支持，观察组接受同步放化疗联合早期综合营养治疗方案，对比两组患者认知水平、干预前后营养状态、免疫功能和远期疗效。结果 观察组营养认知、食欲、功能和饮食配合评分高于对照组（P <0.05）。观察组治疗前后人血白蛋白、血红蛋白的差值高于对照组（P <0.05）。两组患者治疗前后转铁蛋白的差值比较，差异无统计学意义（P >0.05）。观察组治疗前后CD3⁺、CD4⁺、CD4⁺/CD8⁺的差值高于对照组（P <0.05）。两组患者治疗前后CD8⁺的差值比较，差异无统计学意义（P >0.05）。观察组总生存率、疾病特异性生存率、无局部复发率和无远处转移生存率高于对照组（P <0.05）。结论 局部晚期鼻咽癌患者予以同步放化疗联合早期营养治疗方案，可提高认知水平，减少疾病对营养状态和免疫功能的影响，对预后有明显改善作用。

Abstract:

Objective To analyze the value of concurrent chemoradiotherapy combined with early comprehensive nutritional therapy in the treatment of locally advanced nasopharyngeal carcinoma.Methods A total of 100 patients with locally advanced nasopharyngeal carcinoma in our hospital from January 2018 to December 2020 were retrospectively analyzed. The patients were divided into the control group (n = 50) and the observation group (n = 50) according to the intervention methods. The control group was treated with concurrent chemoradiotherapy and given conventional nutritional support, while the observation group received concurrent chemoradiotherapy combined with early comprehensive nutritional therapy. The nutrition knowledge, the nutritional status and immune function before and after intervention, and the long-term efficacy were compared between the groups.Results The scores of nutrition knowledge, appetite, function and dietary adherence in the observation group were higher than those in the control group (P < 0.05). The differences of the levels of blood albumin and hemoglobin before and after treatment in the observation group were higher than those in the control group (P < 0.05). The difference of the level of transferrin before and after treatment was not different between the two groups (P > 0.05). The differences of levels of CD3⁺ and CD4⁺ cells and the ratio of CD4⁺/CD8⁺ cells before and after treatment in the observation group were higher than those in the control group (P < 0.05). The difference of the level of CD8⁺ cells before and after treatment was not different between the two groups (P > 0.05). The overall survival rate, disease-specific survival rate, local recurrence-free rate and distant metastasis-free survival rate of the observation group were significantly higher than those of the control group (P < 0.05).Conclusion For patients with locally advanced nasopharyngeal carcinoma, concurrent chemoradiotherapy combined with early comprehensive nutritional therapy enhances their nutrition knowledge, reduces the impact of the disease on nutritional status and immune function, and significantly improves the prognosis of patients.