内容紹介
Clinical Experience of Nutritional Support in Patients Treated with Chemoradiotherapy for Locally Advanced Esophageal Cancer
Summary
Background: We investigated the efficacy of nutritional support in patients treated with chemoradiotherapy(CRT)for locally advanced esophageal cancer(LAEC). Methods: Eleven patients treated with CRT for locally advanced esophageal squamous cell carcinoma were included. Oral intake energy expenditure(OIE)and total energy expenditure(TEE)of all patients were calculated. Oral nutrition supplementations(ONSs)were utilized as nutritional therapy for the patients with malnutrition(OIE/TEE<0.6). Enteral nutrition(EN)was used in the patients with tumor obstruction. Result: Two patients(18.9%)received ONS and 2 other patients received EN. Seven patients were able to take enough energy in the meal. The mean energy charge was increased from 67.9% to 84.9%. Nine patients(81.8%)completed the treatment regimen. During the CRT period, the prognostic nutritional index(PNI)and C-reactive protein level(mg/dL)were not significantly different. The body mass index decreased to 0.39 kg/m2(p=0.039)and the mean weight loss was 1.57%. The overall response rate was 81.8%. Conclusion: The nutritional support in the patients treated with CRT for LAEC is effective for maintaining nutritional status. Moreover, the response rate is satisfactory.
要旨
目的: 局所進行食道癌に対する,積極的栄養補助の有用性を明らかにする。対象・方法: 過去2年間で,cT4と診断され化学放射線療法(CRT)を施行した頸部・胸部食道扁平上皮癌11例を対象とした。CRTはFP療法と,放射線照射計60 Gyを施行した。栄養アセスメントとして,CRT前の経口摂取エネルギー量(OIE),総エネルギー消費量(TEE)を全例に算出した。OIE/TEE<0.6の全症例に対し経口栄養補助剤(ONS)投与を,狭窄症例には経管栄養(EN)を行い,OIE/TEE≧0.6とした。治療前後での栄養状態の変化について検討した。結果: ONS,EN症例は各2例(18.9%)で,7例は食事のみでOIE/TEE≧0.6を達成できた。介入により,平均OIE/TEEは67.9%から84.9%に上昇した。9例(81.8%)で規定のCRTを完遂できた。PNI,CRP値の変化に有意差はなかった。BMIは0.39 kg/m2減少し(p=0.039),平均体重減少率1.57%,奏効率は81.8%であった。結語: 局所進行食道癌CRT施行症例に対して積極的栄養補助を行うことにより,治療が完遂でき奏効率が上昇することが期待できる。
目次
Summary
Background: We investigated the efficacy of nutritional support in patients treated with chemoradiotherapy(CRT)for locally advanced esophageal cancer(LAEC). Methods: Eleven patients treated with CRT for locally advanced esophageal squamous cell carcinoma were included. Oral intake energy expenditure(OIE)and total energy expenditure(TEE)of all patients were calculated. Oral nutrition supplementations(ONSs)were utilized as nutritional therapy for the patients with malnutrition(OIE/TEE<0.6). Enteral nutrition(EN)was used in the patients with tumor obstruction. Result: Two patients(18.9%)received ONS and 2 other patients received EN. Seven patients were able to take enough energy in the meal. The mean energy charge was increased from 67.9% to 84.9%. Nine patients(81.8%)completed the treatment regimen. During the CRT period, the prognostic nutritional index(PNI)and C-reactive protein level(mg/dL)were not significantly different. The body mass index decreased to 0.39 kg/m2(p=0.039)and the mean weight loss was 1.57%. The overall response rate was 81.8%. Conclusion: The nutritional support in the patients treated with CRT for LAEC is effective for maintaining nutritional status. Moreover, the response rate is satisfactory.
要旨
目的: 局所進行食道癌に対する,積極的栄養補助の有用性を明らかにする。対象・方法: 過去2年間で,cT4と診断され化学放射線療法(CRT)を施行した頸部・胸部食道扁平上皮癌11例を対象とした。CRTはFP療法と,放射線照射計60 Gyを施行した。栄養アセスメントとして,CRT前の経口摂取エネルギー量(OIE),総エネルギー消費量(TEE)を全例に算出した。OIE/TEE<0.6の全症例に対し経口栄養補助剤(ONS)投与を,狭窄症例には経管栄養(EN)を行い,OIE/TEE≧0.6とした。治療前後での栄養状態の変化について検討した。結果: ONS,EN症例は各2例(18.9%)で,7例は食事のみでOIE/TEE≧0.6を達成できた。介入により,平均OIE/TEEは67.9%から84.9%に上昇した。9例(81.8%)で規定のCRTを完遂できた。PNI,CRP値の変化に有意差はなかった。BMIは0.39 kg/m2減少し(p=0.039),平均体重減少率1.57%,奏効率は81.8%であった。結語: 局所進行食道癌CRT施行症例に対して積極的栄養補助を行うことにより,治療が完遂でき奏効率が上昇することが期待できる。