新辅助化学放射治疗对局部晚期直肠癌免疫营养状况的临床影响
Soohyeon Lee1, Dong Hyun Kang1, Tae Sung Ahn1
1Department of Surgery, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea.
根据预后营养指数 (PNI) 和中性粒细胞与淋巴细胞比率 (NLR) 评估的营养状况,对接受化疗或放射治疗 (CRT) 的直肠癌患者产生不良影响. 较低的PNI预测有更高的毒性风险,这表明营养支持可能会改善结果.
科学领域:
- 在瘤学瘤学.
- 临床营养学 临床营养学
- 胃肠病学 胃肠病学
背景情况:
- 营养不良在癌症患者中很常见,影响生存和预后.
- 新辅助化学放射治疗 (CRT) 是局部晚期直肠癌的标准,但其疗效可能取决于营养状况.
- 有限的研究存在于营养状况对新辅助CRT疗效的影响.
研究的目的:
- 研究免疫营养标志物对接受局部晚期直肠癌新辅助CRT的患者的影响.
- 评估营养状况与CRT期间不良反应的发生之间的关系.
- 探索营养标志物对CRT诱导毒性的预测价值.
主要方法:
- 研究了一组131名患有局部晚期直肠癌的患者.
- 在新辅助CRT前后测量了免疫营养标志物,包括预后营养指数 (PNI) 和中性粒细胞与淋巴细胞比率 (NLR).
- 患者被分为低PNI和高PNI组,根据50.92.9的截止值进行分层.
主要成果:
- 低PNI和高PNI两组都显示了淋巴细胞计数和PNI的显著下降,以及CRT后NLR的增加 (P<0.001).
- 低PNI组的患者与高PNI组 (54.8%,P=0.013) 相比,出现不良反应的发生率更高 (76.6%).
- 下胃肠道毒性是最常见的CRT诱导的不良反应.
结论:
- 治疗前的PNI和NLR可以预测新辅助CRT对直肠癌患者急性不良反应的风险.
- 在CRT期间减轻免疫营养变化的营养支持可能会减少副作用.
- 改善营养状况可能有助于提高治疗遵守性和患者的治疗结果.
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