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孙志伟, 贾军, 杨颖, 刘传玲, 肖艳洁, 余靖, 张晓东. 晚期食管癌患者营养状态与化疗疗效及生存的相关性[J]. 肿瘤防治研究, 2017, 44(9): 612-617. DOI: 10.3971/j.issn.1000-8578.2017.17.0158
引用本文: 孙志伟, 贾军, 杨颖, 刘传玲, 肖艳洁, 余靖, 张晓东. 晚期食管癌患者营养状态与化疗疗效及生存的相关性[J]. 肿瘤防治研究, 2017, 44(9): 612-617. DOI: 10.3971/j.issn.1000-8578.2017.17.0158
SUN Zhiwei, JIA Jun, YANG Ying, LIU Chuanling, XIAO Yanjie, YU Jing, ZHANG Xiaodong. Correlation of Baseline Nutritional Status with Response to Chemotherapy and Survival of Advanced Esophageal Cancer Patients[J]. Cancer Research on Prevention and Treatment, 2017, 44(9): 612-617. DOI: 10.3971/j.issn.1000-8578.2017.17.0158
Citation: SUN Zhiwei, JIA Jun, YANG Ying, LIU Chuanling, XIAO Yanjie, YU Jing, ZHANG Xiaodong. Correlation of Baseline Nutritional Status with Response to Chemotherapy and Survival of Advanced Esophageal Cancer Patients[J]. Cancer Research on Prevention and Treatment, 2017, 44(9): 612-617. DOI: 10.3971/j.issn.1000-8578.2017.17.0158

晚期食管癌患者营养状态与化疗疗效及生存的相关性

Correlation of Baseline Nutritional Status with Response to Chemotherapy and Survival of Advanced Esophageal Cancer Patients

  • 摘要:
    目的 评估晚期食管癌患者一线化疗前基线营养状态对化疗疗效、不良反应和患者生存期的影响。
    方法 回顾性收集一线化疗的56例不可手术的局部进展期或转移性食管癌患者的临床资料及化疗前营养状况资料,并分析其与患者化疗疗效、不良反应及生存期的相关性。
    结果 血红蛋白(hemoglobin, Hb)的水平与患者3级以上血液学毒性明显相关,其中Hb > 130 g/L者较90~130 g/L者3级以上血液学毒性的发生率显著降低(34.2% vs. 72.2%, P=0.008),但两者在3级以上非血液学毒性上并无差别(P > 0.05);多因素分析中,有无远处转移和体重下降程度是患者的独立预后因素,有远处转移(P=0.005)、体重下降≥5%(P=0.002)与患者预后差相关。
    结论 对于不可手术的局部进展期或转移性食管癌患者,化疗前基线营养状态在预测化疗不良反应及评估患者预后方面有一定作用。

     

    Abstract:
    Objective To assess the impact of baseline nutritional status on response, toxicity to chemotherapy and survival of the patients with advanced esophageal cancer.
    Methods We collected the clinical data and baseline nutritional status before chemotherapy from the patients with unresectable advanced or metastatic esophageal cancer who had received the first-line chemotherapy. Statistical analysis was performed to identify the correlations of nutritional status with response, toxicity to chemotherapy and survival.
    Results Hemoglobin level was related to grade 3 to 4 hematologic toxicities; the patients with hemoglobin level > 130g/L had lower incidence of grade 3 to 4 hematologic toxicities than those with hemoglobin level 90-130g/L (34.2% vs. 72.2%, P=0.008), but the differences were not statistically significant between their nonhematologic toxicities (P > 0.05). In multivariate analysis, the independent prognostic factors of survival were presence of distant metastases and weight loss. Distant metastases (P=0.005) and weight loss≥5% (P=0.002) were associated with poor prognosis.
    Conclusion In patients with unresectable advanced or metastatic esophageal cancer, baseline nutritional status before chemotherapy may play a role in predicting toxicity to chemotherapy and assessing the prognosis.

     

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