乳腺癌术后辅助化疗患者营养状况与化疗不良反应的关系

目的 探讨乳腺癌术后辅助化疗患者营养状况与化疗不良反应的关系。方法 选取 2014 年 1 月 1 日至2015年 12月31日本院收治的乳腺癌术后辅助化疗患者107例，行AC-T方案化疗；化疗前采用营养风险筛查 2002 （NRS 2002）评分、体质指数 （body mass index，BMI） 评定患者营养风险、营养不足情况，观察化疗不良反应、化疗住院天数、化疗不良事件与营养状况的关系。结果 100例患者纳入研究，营养不足发生率为7%，营养风险发生率为44%。35%和63%的患者出现Ⅲ～Ⅳ级消化道和血液毒性反应，13%的患者出现粒细胞减少性发热。有营养风险组Ⅲ~Ⅳ级血液毒性反应发生率高于无营养风险组，差异有统计学意义（P<0.05）。营养不足组与有营养风险组粒细胞减少性发热的发生率高于无营养不足组及无营养风险组，差异有统计学意义（P<0.05）。有营养风险组平均住院时间长于无营养风险组，差异有统计学意义（P<0.05）。营养不足组与有营养风险组化疗不良事件发生率高于无营养不足组及无营养风险组，差异有统计学意义（P<0.05）。结论 营养不足和有营养风险的乳腺癌患者可能面临更高的术后化疗风险，导致更多不良反应发生，延长住院时间。

Relationship between nutritional status and postoperative adverse reactions to chemotherapy in breast cancer patients

Objective To investigate the relationship between nutritional status and postoperative adverse reactions to adjuvant chemotherapy in breast cancer patients. Methods A total of 100 patients receiving adjuvant chemotherapy （AC-T protocol） after breast cancer surgery were selected from January 1，2014 to December 30，2015. Nutritional risk and malnutrition was assessed before chemotherapy based on the nutritional risk screening 2002 instrument and body mass index （BMI）. Adverse reactions to chemotherapy and hospitalization time were recorded， and their potential relationships with nutritional status were explored. Results Incidence of undernourishment was 7%，and incidence of nutritional risk was 44%. Of the 100 patients，35% showed grade Ⅲ-Ⅳ gastrointestinal reactions， 63% showed grade Ⅲ-Ⅳ hematotoxicity， and 13% showed neutropenic fever. Incidence of gradeⅢ-Ⅳ  hematological toxicity was significantly higher among patients with nutritional risk than among those without risk（P<0.05）. Incidence of neutropenia fever and of adverse events was significantly higher among patients with undernourishment or nutritional risk than among other patients （P<0.05）. Average hospital stay was significantly longer among patients with nutritional risk than among those without nutritional risk（P<0.05）. Conclusion Breast cancer patients with undernutrition or nutritional risk may be at higher risk of postoperative adverse reactions to adjuvant chemotherapy， leading to longer hospital stay.