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肠内营养支持治疗减轻晚期食管癌患者化疗不良反应 被引量:31
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作者 孙志伟 贾军 +4 位作者 杨颖 刘传玲 肖艳洁 余靖 张晓东 《北京大学学报(医学版)》 CAS CSCD 北大核心 2020年第2期261-268,共8页
目的:评估肠内营养支持治疗对晚期食管癌患者一线化疗疗效及不良反应的影响。方法:回顾性收集2014年7月至2016年12月于北京大学肿瘤医院接受一线化疗的118例不可手术切除的局部进展期或转移性食管癌患者资料,将患者分为两组,营养支持组... 目的:评估肠内营养支持治疗对晚期食管癌患者一线化疗疗效及不良反应的影响。方法:回顾性收集2014年7月至2016年12月于北京大学肿瘤医院接受一线化疗的118例不可手术切除的局部进展期或转移性食管癌患者资料,将患者分为两组,营养支持组(化疗同时予肠内营养支持)和对照组(单纯化疗)。比较两组患者化疗前后各营养指标[KPS功能状态评分(Karnofsky performance status)、体质量、体重指数(body mass index,BMI)、血红蛋白、淋巴细胞数、总蛋白、白蛋白、甘油三酯、总胆固醇]的变化及化疗疗效、化疗不良反应的差异。结果:(1)对照组化疗后,患者体质量、BMI和血红蛋白水平均明显下降(P<0.001);营养支持组患者化疗后,患者体质量和BMI并无明显变化,仅血红蛋白有明显下降;两组患者化疗前后其他营养指标差异均无统计学意义。(2)与对照组相比,营养支持组化疗后3级以上血液学毒性发生率显著降低(15.4%vs.42.1%,P=0.004),3级以上非血液学毒性发生率也有所降低但两组差异无统计学意义(0 vs.9.2%,P=0.123)。Logistic回归多因素分析显示,营养治疗是食管癌患者化疗后发生3级以上血液学毒性的独立影响因素(P=0.008,RR=6.048,95%CI:1.589~23.027)。(3)两组患者化疗疗效差异无统计学意义。结论:晚期食管癌患者在化疗同时予肠内营养支持治疗可改善患者营养状态,减轻化疗毒性和不良反应。 展开更多
关键词 食管肿瘤 化疗 肠内营养支持
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The Value of Blood Tumor Markers in the Prognosis of Patients with Unresectable Locally Advanced or Metastatic Gastric Cancer before First-line Chemotherapy
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作者 SUN Zhi-wei JIA Jun +5 位作者 DU Feng liu chuan-ling YU Jing YANG Ying XIAO Yan-jie ZHANG Xiao-dong 《Chinese Journal of Biomedical Engineering(English Edition)》 2019年第1期1-12,共12页
Objective:To study the significance of CEA,CA199,CA72.4 and CA125 in the peripheral blood of patients with advanced or metastatic gastric cancer.Methods:The clinical data of 109 patients with non-operative local advan... Objective:To study the significance of CEA,CA199,CA72.4 and CA125 in the peripheral blood of patients with advanced or metastatic gastric cancer.Methods:The clinical data of 109 patients with non-operative local advanced or metastatic gastric cancer who received first-line chemotherapy in our center from July 2013 to May 2015,and the detection results of CEA,CA199,CA72.4 and CA125 tumor markers before chemotherapy were retrospectively collected,and their correlation with the clinicopathological characteristics and prognosis of the patients were analyzed.Results:The positive rates of CEA,CA199,CA72.4 and CA125 were 46.8%,40.2%,53.5%and 35.0%respectively in 109 cases of gastric cancer,and the positive rates of combined detection of four markers were 87.2%.CEA positive was significantly correlated with liver metastasis(P=0.014),CA125 positive with peritoneal metastasis(P=0.005).In univariate analysis,median PFS(6.3 months vs 11.1 months,P=0.020)and median OS(9.9 months vs 16.9 months,P=0.007)of CA72.4 positive subjects were significantly shorter than those of negative subjects,and median PFS(6.2 months vs 7.8 months,P=0.002)and median OS(9.8 months vs 15.6 months,P=0.009)of CA125 positive subjects were significantly shorter than those of negative subjects.95%CI 1.016-29.601).Of 109 patients,49(45.0%)were low-risk group(0 or 1 risk factor),60(55.0%)were high-risk group(2 to 4 risk factors).The median survival time of low-risk and high-risk groups was 18.5 months and 9.9 months,respectively(P=0.001).Conclusion:CA72.4 and CA125 are related to the prognosis of patients with local advanced or metastatic gastric cancer,and the prognosis model is helpful to stratify the risk of patients and provide the best treatment plan for each patient. 展开更多
关键词 gastric cancer tumor markers CHEMOTHERAPY PROGNOSIS
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