The Evaluation On The Effect Of Entire Nutrition Management In Esophageal Cancer Patients Undergoing Concurrent Chemoradiotherapy

ObjectivesTo explore the effect of entire nutrition management on nutrition status,short-term efficacy,toxic and side effects,quality of life and immune function of esophageal cancer patients undergoing concurrent chemoradiotherapy.It was to provide scientific instructions for standardizing nutrition management of esophageal cancer patients during radiotherapy and chemotherapy.MethodsDuring April 2017 to March 2018,a randomized,controlled,clinical trial was conducted in a Tumor Hospital.A total of 96 patients who were initially diagnosed with esophageal cancer and intended to receive concurrent chemoradiotherapy were included.They were randomly divided into observation group and control group,according to admission sequence,with 48 patients each.All subjects in both groups voluntarily joined this study with informed consents.They have no serious cardiovascular and cerebrovascular diseases,conscious disturbance and communication disorder.During concurrent chemoradiotherapy(the same therapeutic regimen),observation group was received entire nutrition management for 6 weeks,while the control group was received conventional nutrition intervention.Baseline and final data was collected at all stages after admission.Weight,PG-SGA scores,and some hematological indicators were got once a week during hospitalization.What's more,anthropometry,quality of life,immune function and psychologic status and other indexes were also collected before and after intervention.The software SPSS21.0 was used to do statistical analysis.Quantitative data and categorical data were showed by frequency(or constituent ratio)and Mean±SD,respectively.The analysis of independent samples t test was used to evaluate quantitative data.Categorical data was tested by Chi-square test or Rank-sum test(the significant level was 0.05).ResultsThe changes of albumin in experiment group were-2.67±5.38 g/L,while the changes in control group were-6.39±3.50 g/L.The changes of prealbumin were-0.016±0.053 g/L and-0.062±0.052 g/L,respectively.Total protein had reduced by0.44±15.27 g/L and 5.00±4.82 g/L in observation and control group,respectively.Results showed statistical differences in the changes of albmin,prealbumin and total protein,but no significant differences were found in hemoglobin,erythrocyte and other hematological indicators.The incidence of radiation-induced esophagitis was 86.7%and 95.0%in observation group and control group,respectively.The incidence of radiation-induced dermatitis was 28.9%and 55.0%,respectively.The results showed statistical significance in radiation-induced esophagitis and radiation-induced dermatitis between two groups(P<0.05).However,no significant difference in bone marrow suppression and anemia were found(P>0.05).The remission rate in the two groups was 97.8%and 97.5%respectively,which showed no statistical significance(P>0.05).Role function scores in observation group and in control group reduced-0.75±15.21 and-9.44±20.38 respectively,and emotional function scores reduced3.34±13.15 and 0.60±13.37,respectively.The results showed statistical difference in the changes of role function,emotional function,social function,global health status and so on between the two groups(P<0.05).However,no significant difference was detected in the changes of physical function,cognitive function,fatigue and so on(P>0.05).The changes of all indicators on immune function,such as total lymphocyte Count,CD4~+lymphocyte,CD8~+lymphocyte and CD4~+/CD8~+,showed no significant difference between the two groups(P>0.05).The changes of HADS-D scores were-3.50±5.05 and 0.11±3.53 respectively,showing significant difference between observation group and control group(P<0.05).ConclusionsEntire nutrition management can improve nutritional status in esophageal cancer undergoing concurrent chemoradiotherapy.Entire nutrition management can reduce the severity of radiation-induced esophagitis and radiation-induced dermatitis in esophageal cancer patients.Entire nutrition management can improve quality of life and depressive symptoms in esophageal cancer undergoing concurrent chemoradiotherapy.