| Objective: Nutritional status is an important prognostic factor in esophageal cancers with chemoradiotherapy,and it is necessary to improve the nutritional status by nutrition therapy.The purpose of this study was to evaluate the nutritional status and its changes before and after chemoradiotherapy in esophageal cancer using nutritional risk screening 2002(NRS 2002)and patient generated subjective global assessment(PG-SGA),and to explore the effect of nutrition therapy on nutritional status.Methods: Prospectively,38 patients of esophageal cancer treated in hospital from March 2016 to December 2017 were assessed,and nutrition intervention was carried out with five-step treatment of malnutrition.The incidence of nutritional risk and malnutrition,body mass index(BMI),blood biochemical indexes,myelosuppression and clinical response rate at baseline and after chemoradiotherapy were analyzed.Results: Finally,35 male patients completed all this study.Elderly patients accounted for 40%,and middle thoracic stage Ⅲ esophageal cancer was more than one half.There was 85.7% nutritional risk(NRS ≥3)of esophageal cancers before chemoradiotherapy,which was slightly higher than that 68.6% after chemoradiotherapy,although the difference was not statistically significant(P=0.07).The incidence of severe malnutrition(PG-SG≥9)before chemoradiotherapy was 57.1%,which was higher than that 40.0% after chemoradiotherapy.However the incidence of moderate malnutrition(PG-SGA: 4~8),suspicious malnutrition(PG-SGA: 2~3)and good nutrition(PG-SGA: 0~1)were lower at baseline compared with after chemoradiotherapy.These results were no statistically significant difference between the groups(P=0.32).The incidence of grade ≥3 hemoglobin was significantly higher in patients with severe malnutrition,however nutritional status was not significantly correlated with disease control rate and stage.Compared with the patients without nutritional risk,BMI at baseline was significantly lower in patients with nutritional risk before chemoradiotherapy.Besides,BMI and final plasma albumin were also significantly lower in patients with nutritional risk after chemoradiotherapy,but final platelet counts was significantly higher in patients with nutritional risk after chemoradiotherapy.Compared with the patients without severe malnutrition,BMI and final plasma albumin were significantly lower in patients with severe malnutrition before chemoradiotherapy.Besides,BMI,final plasma albumin and final hemoglobin were significantly lower in patients with severe malnutrition after chemoradiotherapy.Compared with baseline,hemoglobin,leukomonocyte and prealbumin were statistically lower after chemoradiotherapy in patients with nutritional risk and severe malnutrition.Only prealbumin was conducted significantly lower in patients without nutritional risk,while no significant difference was conducted in patients without severe malnutrition.Conclusion: The incidence of nutritional risk and malnutrition among patients with locally advanced esophageal cancer was high,because of proper nutrition therapy,there was no significant change after chemoradiotherapy.The nutritional status was significantly correlated with BMI and final plasma albumin.Baseline moglobin,leukomonocyte and prealbumin were statistically higher than after chemoradiotherapy in patients with nutritional risk and severe malnutrition.More studies are warranted. |
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