小野寺预后营养指数与食管鳞癌同步放化疗不良反应的相关性研究

Association between Onodera’s prognostic nutrition index and adverse effects of concurrent chemoradiotherapy for esophageal squamous cell carcinoma

背景与目的:小野寺预后营养指数是由血清白蛋白和外周血淋巴细胞总数计算得出,可以预测晚期肿瘤患者的预后,包括肺癌、食管癌、胃癌、肾癌、结直肠癌和肝癌等,但其与食管鳞癌同步放化疗不良反应的相关性研究较少。探讨小野寺指数对食管鳞癌同步放化疗患者不良反应的预测作用。方法:选取2017年1月—2019年12月于山东大学齐鲁医院放疗科接受同步放化疗的食管鳞癌患者80例,根据小野寺指数将患者分为营养良好组(小野寺指数≥45)和营养不良组(小野寺指数<45),比较两组患者的白细胞减少、血小板减少、恶心呕吐、食管炎、腹泻和肺炎6种急性不良反应。结果:营养不良组食管炎(68.4%vs 45.2%,P=0.045)、腹泻(15.8%vs 2.4%,P=0.034)的发生率高于营养良好组。进一步分析重度不良反应在两组中的差别,发现营养不良组的重度食管炎的发生率显著高于营养良好组(34.2%vs 16.7%,P=0.070),但差异无统计学意义。结论:小野寺指数对食管鳞癌同步放化疗患者的不良反应有较好的预测作用。

Background and purpose: Onodera’s prognostic nutrition index is calculated by the numbers of serum albumin and peripheral blood lymphocytes, which can predict the prognosis of patients with advanced cancers, including lung cancer, esophageal cancer, gastric cancer, renal cancer, colorectal cancer and liver cancer. However, there are few studies on its correlation with adverse effects of concurrent chemoradiotherapy for esophageal squamous cell carcinoma. This study aimed to explore the association between Onodera’s prognostic nutrition index and adverse effects in unresectable esophageal squamous cell carcinoma patients who received concurrent chemoradiotherapy. Methods: Data of 42 good-nourishment(Onodera index≥45) patients and 38 poornourishment(Onodera index<45) patients with esophageal squamous cell carcinoma treated with concurrent chemoradiotherapy were collected. Correlations between Onodera index and the adverse effects were analyzed, including leukopenia, thrombocytopenia, nausea, vomiting, esophagitis, diarrhea and pneumonia. Results: The incidence of esophagitis(68.4% vs 45.2%, P=0.045) and diarrhea(15.8% vs 2.4%, P=0.034) were significantly higher in poor-nourishment group than in good-nourishment group. We further analyzed the difference in severe adverse effects between the two groups. There was a trend that the incidence of severe esophagitis was higher in poor-nourishment group than in good-nourishment group(34.2% vs 16.7%). However, no statistically significant difference was found(P=0.070). Conclusion: Onodera’s prognostic nutrition index has a good predictive effect on the adverse effects in esophageal squamous cell carcinoma patients treated with concurrent chemoradiotherapy.