The Nutritional Status Assessment Of Esophagus Cancer Patients And Study On The Impact Of Nutrition Intervention On Concurrent Radiochemotherapy

Part 1 The nutritional status survey of esophagus cancer patientsObjective:To evaluate clinical significance of nutritional status and nutritional parameters in 108 cases with esophageal cancer by using PG-SGA method.Methods:108 primary esophageal cancer patients were investigated.Patient-Genetated Subjective Global Assessment was applied to conduct regular nutritional assessment.Patients were divided into good nutrition group,mild-to-moderate malnutrition group and severe malnutrition group according to PG-SGA score on admission.We collected height,body weight,leg circumference,laboratory indexes,L3 skeletal muscle mass index and other objective nutrition indicators to evaluate clinical significance of the change of indicators.Results:There were 22 cases with good nutrition(20.4%),49 cases with mild or moderate malnutrition(45.4%),and 37 cases of severe malnutrition(34.3%).The BMI index,the non-profit grip strength,TSF and leg circumference of three groups were compared,and the difference had statistically significant(P<0.05).Serum albumin,prealbumin,hemoglobin and blood urea nitrogen of three groups were compared,the difference had statistically significant(P<0.05).The PG-SGA quantitative evaluation scores and NRS-2002 scores of three groups were compared,the difference was statistically significant(P<0.01).L3 skeletal muscle mass index decreased as the nutritional status decreased,the difference was statistically significant(P<0.05).Conclusion:Primary esophageal cancer patients had a higher incidence of malnutrition.They should be identified early with nutrition screening and assessment,and be given a reasonable nutritional support.Part2 study on the impact of nutrition intervention on concurrent radiochemotherapyObjective:To explore the effects of nutrition intervention on nutrition status,treatment status and life quality of esophageal cancer patients after concurrent radiochemotherapy.Methods:A total of 86 patients in the malnutrition group of the first part were included in this study,and were randomly divided into two groups:the intensive nutrition counseling and oral nutritional supplements(ONS)on nutritional status group and control group.Both groups had the same anti-tumor treatment.The control group was only given regulate nutrition counseling and educatian.In addition to giving enteral nutrition-Nutrison Fibre,the test group also gave extra intensive nutrition counseling.After the radiochemotherapy of esophageal cancer patients,We compared the nutrition scor,physical status score,blood indicators,mmune function index,L3 skeletal muscle mass index,incidence of complications,completion rates of therapy between the two groups.The quality of life was assessed using EORTC QLQ-C30 and QLQ-OES18 in esophageal cancer patients.Results:1.The BMI index and L3 skeletal muscle mass index were significantly higher in the test group after treatment,and the difference was statistically significant(P<0.05).2.The level of prealbumin,hemoglobin,CD3+,CD4+and CD4+/CD8+were all higher in the test group,and the differences were statistically significant(P<0.05),while other hematologic nutrition and immune indexes were not statistically significant(P>0.05).3.Compared with the two groups,the incidence of infectious complications was lower,and the treatment completion rate was higher in the test group(P<0.05).4.There were significant differences in body function,pain,comprehensive quality of life and gastroesophageal reflux symptoms after treatment between the two groups,while there was no statistical difference in scores of other indicators between the two groups.Conclusion:The results showed that Intensive nutrition intervention can help maintain nutrition status,decrease the complications,improve compliance and quality of life for esophageal cancer patients with concurrent radiochemotherapy.