{"title":"不同营养支持方法对头颈癌放疗患者营养状况和免疫功能的影响。","authors":"Jianqi Yang, Erxun Dai, Ting Yin","doi":"10.1007/s12094-024-03640-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to analyze the effects of different nutritional support methods on nutritional status and immune function of patients undergoing radiotherapy for head and neck cancer (HNC).</p><p><strong>Methods: </strong>Patients with HNC were divided into the control (nutritional counseling and routine dietary guidance), parenteral nutrition (PN) (PN support on top of the control group), enteral nutrition (EN) (EN support on top of the control group), and EN + PN (EN combined with PN and routine dietary guidance) groups. After nutrition evaluation, the four groups were subjected to radiotherapy and nutritional support. Body mass index (BMI), serum albumin (ALB), prealbumin (PA), transferrin (TRF), hemoglobin (Hb), CD<sup>3+</sup>, CD<sup>4+</sup>, CD<sup>8+</sup>, CD<sup>4+</sup>/CD<sup>8+</sup>, natural killer (NK) and quality of life were compared among the four groups before radiotherapy and after radiotherapy dose irradiation completion. The incidence of adverse reactions was assessed and recorded at 2 weeks, 4 weeks and the end of radiotherapy.</p><p><strong>Results: </strong>The four groups experienced some degree of malnutrition during radiotherapy and the EN + PN group possessed the lowest degree of malnutrition. After radiotherapy dose irradiation completion (T1), the PN, EN, and EN + PN groups possessed improved BMI (21.42 ± 1.62, 21.40 ± 1.68, 22.98 ± 1.87 vs. 20.18 ± 1.32), serum ALB (31.59 ± 3.49, 32.24 ± 4.23, 37.58 ± 3.23 vs. 26.67 ± 3.03), PA (182.63 ± 13.57, 183.43 ± 14.19, 201.59 ± 10.53 vs. 165.36 ± 20.13), TRF (162.46 ± 24.34, 157.36 ± 18.58, 182.36 ± 20.37 vs. 137.56 ± 23.19), and Hb (128.54 ± 9.21, 125.36 ± 10.23, 140.26 ± 7.23 vs. 103.24 ± 9.47) levels, higher CD3<sup>+</sup> (63.59 ± 2.88, 63.25 ± 3.17, 66.54 ± 1.32 vs. 59.36 ± 3.24), CD4<sup>+</sup> (39.92 ± 3.16, 39.87 ± 3.23, 43.36 ± 2.87 vs. 37.12 ± 4.29), CD4<sup>+</sup>/CD8<sup>+</sup> (1.80 ± 0.06, 1.78 ± 0.06, 2.07 ± 0.03 vs. 1.54 ± 0.10) and NK-cells (33.87 ± 3.62, 33.26 ± 3.59, 36.82 ± 3.19 vs. 27.36 ± 4.21) levels, lower CD8<sup>+</sup> (22.18 ± 1.07, 22.36 ± 1.04, 20.46 ± 1.09 vs. 24.09 ± 1.21) levels, and improved quality of life (79.97 ± 7.96, 80.13 ± 7.98, 91.78 ± 7.38 vs. 71.53 ± 11.70) versus the control group, and the EN + PN group possessed the most pronounced effects (All P < 0.05). During radiotherapy, the incidence of radiotherapy adverse reactions was increased with time (P < 0.05).</p><p><strong>Conclusion: </strong>PN and EN, alone or in combination, can improve the nutritional status, immune function and quality of life of patients undergoing radiotherapy for HNC, and PN combined with EN has the best improvement effect.</p>","PeriodicalId":50685,"journal":{"name":"Clinical & Translational Oncology","volume":" ","pages":"1310-1319"},"PeriodicalIF":2.8000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effects of different nutritional support methods on nutritional status and immune function in patients undergoing radiotherapy for head and neck cancer.\",\"authors\":\"Jianqi Yang, Erxun Dai, Ting Yin\",\"doi\":\"10.1007/s12094-024-03640-z\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This study aimed to analyze the effects of different nutritional support methods on nutritional status and immune function of patients undergoing radiotherapy for head and neck cancer (HNC).</p><p><strong>Methods: </strong>Patients with HNC were divided into the control (nutritional counseling and routine dietary guidance), parenteral nutrition (PN) (PN support on top of the control group), enteral nutrition (EN) (EN support on top of the control group), and EN + PN (EN combined with PN and routine dietary guidance) groups. After nutrition evaluation, the four groups were subjected to radiotherapy and nutritional support. Body mass index (BMI), serum albumin (ALB), prealbumin (PA), transferrin (TRF), hemoglobin (Hb), CD<sup>3+</sup>, CD<sup>4+</sup>, CD<sup>8+</sup>, CD<sup>4+</sup>/CD<sup>8+</sup>, natural killer (NK) and quality of life were compared among the four groups before radiotherapy and after radiotherapy dose irradiation completion. The incidence of adverse reactions was assessed and recorded at 2 weeks, 4 weeks and the end of radiotherapy.</p><p><strong>Results: </strong>The four groups experienced some degree of malnutrition during radiotherapy and the EN + PN group possessed the lowest degree of malnutrition. After radiotherapy dose irradiation completion (T1), the PN, EN, and EN + PN groups possessed improved BMI (21.42 ± 1.62, 21.40 ± 1.68, 22.98 ± 1.87 vs. 20.18 ± 1.32), serum ALB (31.59 ± 3.49, 32.24 ± 4.23, 37.58 ± 3.23 vs. 26.67 ± 3.03), PA (182.63 ± 13.57, 183.43 ± 14.19, 201.59 ± 10.53 vs. 165.36 ± 20.13), TRF (162.46 ± 24.34, 157.36 ± 18.58, 182.36 ± 20.37 vs. 137.56 ± 23.19), and Hb (128.54 ± 9.21, 125.36 ± 10.23, 140.26 ± 7.23 vs. 103.24 ± 9.47) levels, higher CD3<sup>+</sup> (63.59 ± 2.88, 63.25 ± 3.17, 66.54 ± 1.32 vs. 59.36 ± 3.24), CD4<sup>+</sup> (39.92 ± 3.16, 39.87 ± 3.23, 43.36 ± 2.87 vs. 37.12 ± 4.29), CD4<sup>+</sup>/CD8<sup>+</sup> (1.80 ± 0.06, 1.78 ± 0.06, 2.07 ± 0.03 vs. 1.54 ± 0.10) and NK-cells (33.87 ± 3.62, 33.26 ± 3.59, 36.82 ± 3.19 vs. 27.36 ± 4.21) levels, lower CD8<sup>+</sup> (22.18 ± 1.07, 22.36 ± 1.04, 20.46 ± 1.09 vs. 24.09 ± 1.21) levels, and improved quality of life (79.97 ± 7.96, 80.13 ± 7.98, 91.78 ± 7.38 vs. 71.53 ± 11.70) versus the control group, and the EN + PN group possessed the most pronounced effects (All P < 0.05). During radiotherapy, the incidence of radiotherapy adverse reactions was increased with time (P < 0.05).</p><p><strong>Conclusion: </strong>PN and EN, alone or in combination, can improve the nutritional status, immune function and quality of life of patients undergoing radiotherapy for HNC, and PN combined with EN has the best improvement effect.</p>\",\"PeriodicalId\":50685,\"journal\":{\"name\":\"Clinical & Translational Oncology\",\"volume\":\" \",\"pages\":\"1310-1319\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2025-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical & Translational Oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s12094-024-03640-z\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/8/18 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical & Translational Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s12094-024-03640-z","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/8/18 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
研究目的本研究旨在分析不同营养支持方法对头颈癌(HNC)放疗患者营养状况和免疫功能的影响:方法:将 HNC 患者分为对照组(营养咨询和常规饮食指导)、肠外营养组(在对照组基础上给予肠外营养支持)、肠内营养组(在对照组基础上给予肠内营养支持)和肠内营养+肠内营养组(肠内营养结合肠外营养和常规饮食指导)。营养评估后,四组患者接受放疗和营养支持。在放疗前和放疗剂量照射完成后,比较四组患者的体重指数(BMI)、血清白蛋白(ALB)、前白蛋白(PA)、转铁蛋白(TRF)、血红蛋白(Hb)、CD3+、CD4+、CD8+、CD4+/CD8+、自然杀伤因子(NK)和生活质量。在放疗2周、4周和结束时,对不良反应的发生率进行了评估和记录:结果:四组患者在放疗期间都出现了一定程度的营养不良,其中 EN + PN 组的营养不良程度最低。放疗剂量照射结束后(T1),PN 组、EN 组和 EN + PN 组的 BMI(21.42±1.62、21.40±1.68、22.98±1.87 vs. 20.18±1.32)、血清 ALB(31.59±3.49、32.24±4.23、37.58±3.23 vs. 26.67±3.03)、PA(182.63±13.57、183.43±14.19、201.59±10.53 vs. 165.36±20.13)、TRF(162.46±24.34、157.36±18.58、182.36±20.37 vs. 137.56±23.19)和 Hb(128.54±9.21、125.36±10.23、140.26±7.23 vs. 103.24±9.47)水平,CD3+(63.59±2.88、63.25±3.17、66.54 ± 1.32 vs. 59.36 ± 3.24)、CD4+(39.92 ± 3.16、39.87 ± 3.23、43.36 ± 2.87 vs. 37.12 ± 4.29)、CD4+/CD8+(1.80 ± 0.06、1.78 ± 0.06, 2.07 ± 0.03 vs. 1.54 ± 0.10)和 NK 细胞(33.87 ± 3.62, 33.26 ± 3.59, 36.82 ± 3.19 vs. 27.36 ± 4.21)水平,CD8+(22.与对照组相比,EN + PN 组疗效最显著(所有 P 均为结论):PN和EN单独或联合应用可改善HNC放疗患者的营养状况、免疫功能和生活质量,其中PN联合EN的改善效果最佳。
Effects of different nutritional support methods on nutritional status and immune function in patients undergoing radiotherapy for head and neck cancer.
Objective: This study aimed to analyze the effects of different nutritional support methods on nutritional status and immune function of patients undergoing radiotherapy for head and neck cancer (HNC).
Methods: Patients with HNC were divided into the control (nutritional counseling and routine dietary guidance), parenteral nutrition (PN) (PN support on top of the control group), enteral nutrition (EN) (EN support on top of the control group), and EN + PN (EN combined with PN and routine dietary guidance) groups. After nutrition evaluation, the four groups were subjected to radiotherapy and nutritional support. Body mass index (BMI), serum albumin (ALB), prealbumin (PA), transferrin (TRF), hemoglobin (Hb), CD3+, CD4+, CD8+, CD4+/CD8+, natural killer (NK) and quality of life were compared among the four groups before radiotherapy and after radiotherapy dose irradiation completion. The incidence of adverse reactions was assessed and recorded at 2 weeks, 4 weeks and the end of radiotherapy.
Results: The four groups experienced some degree of malnutrition during radiotherapy and the EN + PN group possessed the lowest degree of malnutrition. After radiotherapy dose irradiation completion (T1), the PN, EN, and EN + PN groups possessed improved BMI (21.42 ± 1.62, 21.40 ± 1.68, 22.98 ± 1.87 vs. 20.18 ± 1.32), serum ALB (31.59 ± 3.49, 32.24 ± 4.23, 37.58 ± 3.23 vs. 26.67 ± 3.03), PA (182.63 ± 13.57, 183.43 ± 14.19, 201.59 ± 10.53 vs. 165.36 ± 20.13), TRF (162.46 ± 24.34, 157.36 ± 18.58, 182.36 ± 20.37 vs. 137.56 ± 23.19), and Hb (128.54 ± 9.21, 125.36 ± 10.23, 140.26 ± 7.23 vs. 103.24 ± 9.47) levels, higher CD3+ (63.59 ± 2.88, 63.25 ± 3.17, 66.54 ± 1.32 vs. 59.36 ± 3.24), CD4+ (39.92 ± 3.16, 39.87 ± 3.23, 43.36 ± 2.87 vs. 37.12 ± 4.29), CD4+/CD8+ (1.80 ± 0.06, 1.78 ± 0.06, 2.07 ± 0.03 vs. 1.54 ± 0.10) and NK-cells (33.87 ± 3.62, 33.26 ± 3.59, 36.82 ± 3.19 vs. 27.36 ± 4.21) levels, lower CD8+ (22.18 ± 1.07, 22.36 ± 1.04, 20.46 ± 1.09 vs. 24.09 ± 1.21) levels, and improved quality of life (79.97 ± 7.96, 80.13 ± 7.98, 91.78 ± 7.38 vs. 71.53 ± 11.70) versus the control group, and the EN + PN group possessed the most pronounced effects (All P < 0.05). During radiotherapy, the incidence of radiotherapy adverse reactions was increased with time (P < 0.05).
Conclusion: PN and EN, alone or in combination, can improve the nutritional status, immune function and quality of life of patients undergoing radiotherapy for HNC, and PN combined with EN has the best improvement effect.
期刊介绍:
Clinical and Translational Oncology is an international journal devoted to fostering interaction between experimental and clinical oncology. It covers all aspects of research on cancer, from the more basic discoveries dealing with both cell and molecular biology of tumour cells, to the most advanced clinical assays of conventional and new drugs. In addition, the journal has a strong commitment to facilitating the transfer of knowledge from the basic laboratory to the clinical practice, with the publication of educational series devoted to closing the gap between molecular and clinical oncologists. Molecular biology of tumours, identification of new targets for cancer therapy, and new technologies for research and treatment of cancer are the major themes covered by the educational series. Full research articles on a broad spectrum of subjects, including the molecular and cellular bases of disease, aetiology, pathophysiology, pathology, epidemiology, clinical features, and the diagnosis, prognosis and treatment of cancer, will be considered for publication.