28例晚期口腔鳞癌患者新辅助化疗围化疗期营养状况及生活质量评估

目的: 探讨晚期口腔鳞癌患者新辅助化疗围化疗期的营养状况、生活质量变化和两者的相关性,以及化疗对营养状况和生活质量的影响。方法: 选择2019年6月—2019年12月于上海交通大学附属第九人民医院口腔颌面-头颈肿瘤科行新辅助化疗的晚期口腔鳞癌患者28例,采用队列研究方法。所有患者均以TPF方案(多西他赛+顺铂+5-氟尿嘧啶)进行化疗,化疗期间采用个体化方案进行营养支持。分析患者化疗前、后PG-SGA、QLQ-H&N35评分变化以及两者的相关性,并根据肿瘤消退情况,将患者分为有反应组(CR+PR)和无反应组(PD+SD)进行分层分析。采用 SPSS 23.0软件包对数据进行统计学分析。结果: 化疗后患者的PG-SGA评分和QLQ-H&N35评分较化疗前显著降低(P=0.0301,P=0.0015),两者之间具有显著的相关性(r=0.5953,P<0.0001)。分层分析显示,有反应组和无反应组患者的PG-SGA评分与QLQ-H&N35评分变化无统计学差异(P>0.05)。2组患者的体重、肌肉量和脂肪量变化均无统计学差异。排除女性患者后发现,2组患者体重及脂肪量变化无显著差异(P>0.05),但有反应组患者的肌肉量显著增多而无反应组患者的肌肉量显著下降(P=0.0358)。结论: 新辅助化疗能够改善晚期口腔鳞癌患者的营养状况,提高患者生活质量。

Nutritional status and quality of life in 28 patients with advanced oral squamous cell carcinoma during neoadjuvant chemotherapy

PURPOSE: To explore the changes of nutritional status and quality of life in patients with advanced oral squamous cell carcinoma(OSCC) during neoadjuvant chemotherapy and their correlation, and evaluate the effect of chemotherapy on nutritional status and quality of life. METHODS: During June 2019 to December 2019, 28 patients with advanced OSCC who received neoadjuvant chemotherapy in the Department of Oromaxillofacial Head and Neck Oncology of Shanghai Ninth People's Hospital were enrolled in the cohort study. TPF regimen (docetaxel+cisplatin+5-fluorouracil) was used in the whole group. During chemotherapy, individual regimen was used for nutritional support. The changes of PG-SGA, QLQ-H&N35 scores and their correlation before and after the chemotherapy were analyzed. The patients were divided into the response group (CR+PR) and the non-response group (PD+SD) for stratified analysis according to the tumor regression using SPSS 23.0 software package. RESULTS: The PG-SGA score and QLQ-H&N35 score of patients after chemotherapy were significantly lower than those before chemotherapy(P=0.0301; P=0.0015), and there was significant correlation between them(r=0.5953, P<0.0001). Stratified analysis showed that there was no significant difference in PG-SGA score and QLQ-H&N35 score between response group and non-response group(P>0.05). There was no significant difference in body weight, muscle mass and fat mass between the two groups (P>0.05). There was no significant difference in body weight and fat between the two groups(P>0.05), but there was significant increase in muscle mass in response group and significant decrease in muscle mass in the non-response group(P=0.0358). CONCLUSIONS: Neoadjuvant chemotherapy can improve the nutritional status and quality of life of patients with advanced OSCC.