The Correlation Study Between Radiosensitivity In Human Nasopharyngeal Carcinoma And Nutrition Status

[Objective]To investigate the integrated nutritional status of patients with nasopharyngealcarcinoma before radiotherapy, and explore the relationship between nutritionalstatus and radiosensitivity. To provide an alternative predictive indicator forradiosensitivity so that it is beneficial to improve the efficacy of radiotherapy fornasopharyngeal carcinoma.[Methods]Patients who were primarily diagnosed as nasopharyngeal carcinoma anduederwent intensity-modulated radiotherapy were enrolled in this study in thedepartment of Radiation of the First Affiliate Hospital of Fujian Medical Universityfrom October,2008to December,2011. The demographic data(age, gender, inhabitedarea, marital status, vocation, educational background, average monthly income,health care cost, smoking, drinking), clinical informations(clinical stage, pathology,history of chronic illness, radiation dose, chemotherapy history before radiotherapy,distant metastasis) and nutritional status(body height, body weight, armcircumference, triceps skinfold thickness, body mass index and hematologyindex—albumin, lymphocyte, erythrocyte, haematoglobin, serum prealbumin,transferrin) were collected by trained interviewers with self-constructedquestionnaires. According to the MRI of patients3months after radiotherapy,WHO solid tumor response evaluation criteria was used to assess recent effect. Anutrition index model was built to assess the nutritional status by principalcomponents analysis. In order to find the optimal prediction cut-off point, ROCcurve and curve estimation were used to analyze the nutritional index. Influencingfactors of radiosensitivity were analyzed by Independent-samples t test, chi-squaredtest,Fisher test,nonparametric test and unconditional Logistic regression. All data were entered by Epidata3.1and statistical analysis was carried out using SPSS13.0.[Results]1. According to the WHO solid tumor response evaluation criteria, there were73(75.3%) persons complete response and24(24.7%) persons partial response duringall97patients who have complete clinical data and MRI data. Patients had historyof chronic illness have better radiotherapy efficacy compare to patients withouthistory of chronic illness （χ2=5.118, p=0.024）. Meanwhile there was a significantdifference in the pathology between radio-sensitive group and radio-insensitive group（p=0.028）.2. Univariate analysis showed that there was a significant difference in the armcircumference, albumin,hemoglobin, prealbumin and nutrition index(NI) betweenradio-sensitive group group and radio-insensitive group. The t values were-2.763，-2.145，-2.531，-2.261，-2.667respectively and p values were0.007，0.034，0.013,0.026，0.009. The nutritional indicators of radio-sensitive group was higher thanradio-insensitive group.3. ROC curve and curve estimation analysis demonstrated that, when nutritionindex was0.431,the cut-off point was optimal. Sensitivity and specificity were0.917and0.370respectively.4.Multivariate Logistic regression analysis performed that history of chronic illnessand integrated nutrition index were independent factors affecting radiosensitivity.[Conclusion]1. History of chronic illness, pathology and nutritional status were theinfluencing factors of radiosensitivity in human nasopharyngeal carcinoma.2. The bad nutritional status was significantly associated with badnasopharyngeal carcinoma radiosensitivity, and may become an important indicatorto predict the radiosensitivity.3. Our suggestion is that patients whose nutrition index is less than0.431,should be given nutritional support while the others should not.