营养支持在癌症患者化疗中的作用

E. Galeeva, A. Stepanova, A. Kostin
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摘要

介绍。营养支持是多模式癌症治疗的重要组成部分。众所周知,适当的营养补充必要的营养素可以支持肌肉及其功能,减少癌症治疗相关并发症的发生率和严重程度,并促进康复。根据患者对能量(30千卡/千克体重/天)、蛋白质(1.5克蛋白质/千克体重/天)和二十碳五烯酸(2克/天)的需求计划适当的营养支持。材料和方法。我们分析了2019年至2021年间在P.A. Herzen莫斯科肿瘤研究所(俄罗斯卫生部国家医学放射学研究中心分支机构)接受治疗的632名癌症患者的营养状况动态。研究参与者分为两组:实验组(n = 316)和对照组(n = 316)。实验组患者给予适当的营养支持。该研究包括确诊的胃肠道癌症(食道癌和胃癌)、结肠癌、头颈癌和肺癌患者。药物抗肿瘤治疗过程中的营养治疗改善了头颈部、肺部、上胃肠道肿瘤患者的营养状况。研究结果表明,在这些亚组中,患者的体重有增加的趋势,而在对照组中,与初始指标相比,体重有统计学显著下降9.4;9.5;分别为5.3和9.6 kg。同时,充分的临床营养使上消化道癌和结肠癌、直肠癌患者的总蛋白水平分别提高4.0 g/l和3.7 g/l,达到统计学趋势水平。白蛋白水平仅在肺癌患者中显著升高(6.6 g/l)。患者在全身治疗期间营养状况的改善确保了周期间频率减少6%,剂量校正需要减少0.2 - 3.4%,癌症治疗阶段的完全性增加2.9 - 11.1%(趋势)。我们的研究结果表明,化疗期间额外的专业(口服或肠内)营养支持可以稳定体重及其指数,首先可以提高治疗耐受性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effects of nutritional support in cancer patients receiving chemotherapy
Introduction. Nutritional support is an important component of multimodal cancer therapy. It is well known that proper nutrition supplemented by necessary nutrients can support muscles and their function, reduce the incidence and severity of complications associated with cancer therapy, and facilitate recovery. Proper nutritional support is planned according to patient’s need for energy (30 kcal / kg body weight per day), protein (1.5 g protein / kg body weight per day), and eicosapentaenoic acid (2 g per day).Materials and methods. We analyzed the dynamics of nutritional status of 632 cancer patients treated in P.A. Herzen Moscow Oncology Research Institute – a branch of the National Medical Radiology Research Center, Ministry of Health of Russia between 2019 and 2021. Study participants were divided into two groups: experimental (n = 316) and control (n = 316). Patients in the experimental group received proper nutritional support. This study included patients with confirmed gastrointestinal cancers (esophageal and gastric), colon cancer, head and neck cancer, and lung cancer.Results. Nutritional therapy in the process of drug antitumor treatment has improved the trophological status of patients with tumors of the head and neck, lungs, upper gastrointestinal tract. As a result of the work, there was a tendency to increase the body weight of patients in these subgroups, whereas in the control group there was a statistically significant decrease in body weight compared to the initial indicators by 9.4; 9.5; 5.3 and 9.6 kg, respectively. Also, full clinical nutrition contributed to an increase in the level of total protein in patients with cancer of the upper gastrointestinal tract and colon and rectum by 4.0 and 3.7 g/l, respectively, at the level of statistical trend. The level of albumin significantly increased (by 6.6 g/l) only in patients with lung cancer.Improved nutritional status of patients during their systemic therapy ensured a 6 % reduction in the frequency of intercycle periods, a 0.2–3.4 % reduction in the need for dosage correction, and a 2.9–11.1 % increase in the completeness of cancer therapy stages (trend).Conclusion. Our findings suggest that additional specialized (oral or enteral) nutritional support during chemotherapy stabilizes body weight and its index, resulting, first of all, in improved tolerability of treatment.
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