放疗患者的营养治疗指南(2024版)

Nutritional therapy guidelines for radiotherapy patients(2024 Edition)

放射治疗(以下简称“放疗”)是恶性肿瘤治疗中的关键手段,其效果显著,不仅有效减轻肿瘤负担、缓解相关症状,还可能影响患者的营养状态。放疗可以干扰营养物质的摄入、消化、吸收及代谢,易导致或加剧营养不良,成为放疗患者的常见并发症。鉴于营养不良对预后和生活质量的负面影响,对放疗患者实施系统、规范的营养评估与干预至关重要。在此,营养风险筛查2002(NRS 2002)量表因其科学性与实用性,被推荐为首选筛查工具;而患者主观整体评估(PG-SGA)量表则以其全面性和敏感性,在营养评估中占据重要地位,为个性化营养干预提供依据。针对患者营养状况的动态变化,倡导灵活多变的策略,如适时调整治疗路径、优化肠内与肠外营养治疗、个性化能量与蛋白质需求设定、免疫营养素合理补充,并鼓励患者参与体力活动。这些综合措施旨在全面改善患者围放疗期的营养状况,减轻放疗不良反应,提升患者耐受性,增强肿瘤细胞对放疗的敏感性,从而优化治疗效果,有望提升疗效和改善患者生活质量。

Radiotherapy is a key method in the treatment of malignant tumors,which has significant benefits.It not only ffectively reduces the burden of tumors and relieves related symptoms,but also deeply affects the nutritional status of patients.However,the process of radiotherapy complexly interferes with the intake,digestion,absorption,and metabolism of nutrients,which can easily lead to or aggravate malnutrition,becoming a common complication of radiotherapy patients.In view of the significant negative impact of malnutrition on prognosis and quality of life,it is essential to implement systematic and standardized nutritional assessment and intervention for radiotherapy patients.Therefore,nutritional risk screening 2002(NRS 2002)scale is recommended as the preferred screening tool because of its scientifie and practical nature.However,the patient-generated subjective global assessment(PG--SGA)plays an important role in nutritional assessment due to its comprehensiveness and sensitivity,and provides a basis for personalized nutritional intervention.In view of the dynamie changes in nutritional status of patients,we advocate flexible strategies,such as timely adjustment of treatment pathways,optimization of enteral and parenteral nutrition support,personalized energy and protein requirements setting,reasonable supplementation of immune nutrients,and encouraging patients to participate in physical activity.These comprehensive measures are aimed at comprehensively improving the nutritional status of patients during the perioperative period of radiotherapy,reducing the adverse reactions of radiotherapy,improving the tolerance of patients,and enhancing the sensitivity of tumor cells to radiotherapy,so as to optimize the therapeutic effect.Both in the short and long term,they are expected to significantly improve the fficacy and ultimately improve the overall quality of life of patients.