免疫营养在消化道恶性肿瘤放化疗中的应用

Application of immunonutrition in radiotherapy and chemotherapy of digestive tract malignant tumor

在我国,消化道恶性肿瘤的发病率及死亡率一直处于较高水平,手术及放化疗是其主要治疗手段。50%~70%的消化道恶性肿瘤患者由于机体的高代谢及应激反应等出现营养不良风险,对于接受手术或放化疗的老年患者,营养不良风险会进一步增加。放化疗引起的厌食、恶心、呕吐及吸收功能障碍等易导致患者体重丢失和营养不良风险增加或出现营养不良,增加放化疗不良反应风险,导致放化疗疗效降低,甚至治疗中断,从而影响患者的生活质量及预后。因此,营养治疗对放化疗肿瘤患者至关重要。近年来,免疫营养素在临床上被广泛应用于消化道恶性肿瘤患者的营养治疗,已成为肿瘤营养治疗的一个发展方向。免疫营养有助于改善消化道恶性肿瘤放化疗患者的免疫功能及炎症水平,增强患者对放化疗的耐受性及敏感性,提升化疗疗效,提高患者生活质量,延长生存期等,但免疫营养在消化道恶性肿瘤放化疗患者中的作用效果报道不一,仍待深入研究。本文就国内外免疫营养在消化道恶性肿瘤放化疗患者中的研究现状进行综述,以探索免疫营养对消化道恶性肿瘤放化疗患者的理想治疗策略,对于未来改善患者生活质量及疾病转归提供潜在的参考价值。

In China,the morbidity and mortality of digestive tract malignant tumors are always at a high level,and surgery,radiotherapy and chemotherapy are the main treatment methods.Studies have found that 50%-70%of patients with digestive tract malignant tumors are at risk of malnutrition due to the body’s high metabolism and stress response.The risk of malnutrition increases,especially in older patients undergoing surgery or chemotherapy.Anorexia,nausea,vomiting and absorption disorders caused by radiotherapy and chemotherapy easily lead to weight loss and malnutrition risk or malnutrition of patients,increase the occurrence of adverse reactions to radiotherapy and chemotherapy,resulting in reduced efficacy or even treatment interruption,thus affecting the quality of life and prognosis of patients.Therefore,nutritional therapy is very important for tumor patients with radiotherapy and chemotherapy.In recent years,immunonutrients have been widely used in the nutrition of patients with digestive tract malignant tumors,and have become a developing direction of tumor nutrition therapy.The immune nutrition helps to improve the immune function in patients with digestive tract malignant tumor radiation and chemotherapy and inflammation levels,enhance the sensitivity,and tolerability of radiation and chemotherapy patients improve chemotherapy treatment,improve the patients life quality,prolong the survival period,etc.,but the immune effect of nutrition in the digestive tract malignant tumor radiation and chemotherapy patients reported is differ,still to be further study.In this paper,the research status of immunonutrition in patients with gastrointestinal malignancy was reviewed,in order to explore the ideal therapeutic strategy of immunonutrition for patients with gastrointestinal malignancy,and provide potential reference value for improving patients’quality of life and disease outcome in the future.