| 摘要(英) | The purpose of this study was to assess the nutritional status of patients with esophageal cancer before and during receiving concurrent chemo-radiotherapy, and to evaluate the nutritional status in patients with different feeding routes including oral intake, nasogastric tube feeding and jejunostomy feeding. Forty-five patients were recruited from Linko Chang-Gung Memorial Hospital, 27 for oral intake, 12 for nasogastric tube feeding and 6 for jejunostomy feeding. The anthropometric and pathologic data in first diagnosis were analyzed. And the assessment in nutritional status, including body weight, triceps skinfold, mid arm circumference, mid arm muscle circumference, hemoglobin and serum albumin, were measured during receiving first, second, third and fourth courses of chemotherapy. The results showed that the average period of dysphagia is 2.4 ± 1.8 months, average body losses is 9.5 ± 7.2 %, average mid arm circumference is 26.0 ± 2.8cm and mid aim muscle circumference is 23.1 ± 2.2 cm. The body weight losses in nasogastric tube and jejunostomy feeding groups were significantly higher than oral intake group at diagnosis (p=0.017). Mid arm circumference and mid arm muscle circumference in nasogastric tube group was significantly lower than oral intake group (p＜0.05). After concurrent chemo-radiotherapy and surgery, the body weight, triceps skinfold and mid arm circumference in oral intake group were significantly lower after surgery (p＜0.05). In addition, the hemoglobin and mid arm muscle circumference were significantly decreased (p＜0.0001). There was no difference of blood biochemical values and anthropometrical measures of the other two groups before and after surgery. By using multiple regression analysis, patient’s nutritional status at diagnosis was significantly affected by the period of dysphagia, severity of lumen obstruction and tumor location (p＜0.05). How-ever, nutrition status during treatment was significantly affected by feeding route, severity of lumen obstruction, treatment type, treatment responses and tumor location (p＜0.05). Therefore, enteral feeding should be introduced to esophageal cancer patients, who suffered from dysphagia, poor intake or persisted body weight loss, before and during concurrent chemo-radiotherapy, to prevent malnutrition. And enteral feeding should maintain patient’s good nutritional status after surgery. |
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