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营养干预对胰腺癌患者放化疗疗效及不良反应的影响
龚杨洋1,2,张火俊2*
0
(1. 海军军医大学(第二军医大学)基础医学院学员一大队, 上海 200433;
2. 海军军医大学(第二军医大学)第一附属医院放射治疗科, 上海 200433
*通信作者)
摘要:
胰腺癌患者的营养不良风险在所有癌症中最高,而放化疗可能会进一步加剧胰腺癌患者的营养不良状况。营养不良不仅会降低放化疗的疗效,还会增加不良反应,对患者的生活质量和预后产生不利影响。因此,在胰腺癌患者的治疗过程中,营养干预尤为重要。研究表明,营养干预能有效改善胰腺癌相关恶病质,降低患者出现营养不良的风险,进而保持对放化疗的敏感性、耐受性,减轻不良反应,减少辅助治疗和手术治疗的并发症;营养干预联合放化疗能够破坏胰腺癌的代谢并抑制肿瘤生长,降低患者住院率,改善患者生活质量。本文主要从营养评估的方式、胰腺癌患者营养干预措施及营养干预对胰腺癌患者放化疗疗效及不良反应的影响这几个方面进行综述。
关键词:  胰腺肿瘤  放射疗法  化学疗法  营养不良  营养疗法
DOI:10.16781/j.CN31-2187/R.20240436
投稿时间:2024-06-18修订日期:2024-09-25
基金项目:国家自然科学基金面上项目(82272742,82473233),上海市卫生健康委员会领军人才计划(2022LJ019),国家重点研发计划(2022YFC2503701),海军军医大学(第二军医大学)第一附属医院“固海”计划(GH145-33).
Effect of nutrition intervention on efficacy and adverse reactions of radiochemotherapy in pancreatic cancer patients
GONG Yangyang1,2,ZHANG Huojun2*
(1. The First Student Team, College of Basic Medical Sciences, Naval Medical University (Second Military Medical University), Shanghai 200433, China;
2. Department of Radiotherapy, The First Affiliated Hospital of Naval Medical University (Second Military Medical University), Shanghai 200433, China
*Corresponding author)
Abstract:
Pancreatic cancer patients are at the highest risk of malnutrition among all cancer patients, and radiochemotherapy may further exacerbate the risk of malnutrition in these patients. Malnutrition can reduce the therapeutic efficacy of radiochemotherapy and increase adverse reactions, thereby adversely impacting patients’ quality of life and prognosis. Consequently, nutrition intervention is particularly crucial in the management of pancreatic cancer. Researches have shown that nutrition intervention can effectively ameliorate cachexia associated with pancreatic cancer, reduce the risk of malnutrition, and thereby maintain the sensitivity and tolerance to radiochemotherapy, alleviate adverse reactions, and reduce the complications of adjuvant therapy and surgical treatment. The combination of nutrition intervention and radiochemotherapy can disrupt the metabolism of pancreatic cancer and inhibit tumor growth, reduce the hospitalization rate of patients, and improve their quality of life. This review discusses the methods of nutritional assessment, nutrition intervention strategies for pancreatic cancer patients, and the impact of nutrition intervention on the efficacy and adverse reactions of radiochemotherapy in pancreatic cancer patients.
Key words:  pancreatic cancer  radiotherapy  chemotherapy  malnutrition  nutrition therapy