摘要
目的探讨补充谷氨酰胺(glutamine,GLN)对预防晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者急性放射治疗诱发的食管炎(acute radiation-induced esophagitis,ARIE)的临床价值。方法选取2018年8月至2021年8月广西中医药大学附属瑞康医院收治并诊断为NSCLC的100例患者作为研究对象,根据治疗方案的不同分为对照组与实验组,每组50例。对照组行常规放化疗,实验组在对照组基础上口服预防性GLN,比较两组ARIE及体质量变化情况、不良反应发生率、无进展生存期(progression-free survival,PFS)和总生存期(overal survival,OS)。结果两组均未出现≥4级ARIE;实验组2~3级ARIE占比低于对照组,2~3级ARIE起始发作中位时间长于对照组,体质量减轻占比低于对照组,体质量变化值高于对照组,差异有统计学意义(P<0.05)。两组放化疗期间均未出现≥3级恶心或呕吐、≥4级晚期食道毒性,两组恶心和呕吐发生率比较差异无统计学意义;实验组晚期食道毒性发生率低于对照组(P<0.05)。两组PFS和OS比较差异无统计学意义。结论补充GLN可减少晚期NSCLC患者因放化疗引起的ARIE和体质量减轻,并推迟ARIE起始发作时间,提高患者的生存质量,具有较好的临床价值。
Objective To investigate the clinical value of glutamine(GLN)supplementation in the prevention of acute radiation-induced esophagitis(ARIE)in patients with advanced non-small cell lung cancer(NSCLC).Methods A total of 100 patients diagnosed with NSCLC who were treated at Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine from August 2018 to August 2021 were selected as the research subjects,and they were divided into the experimental group and the control group according to the treatment regimen,with 50 cases in each group.The control group received conventional chemoradiotherapy,while the experimental group received additional prophylactic oral GLN on the basis of the control group.The ARIE,body weight changes,incidence of adverse reactions,progression-free survival(PFS),and overall survival(OS)were compared between the two groups.Results There was no≥4 ARIE in the two groups;the proportion of grade 2-3 ARIE in the experimental group was lower than that in the control group,the median onset time of grade 2-3 ARIE was longer than that in the control group,the proportion of weight loss was lower than that in the control group,and the value of weight change was higher than that in the control group,the differences were statistically significant(P<0.05).There was no grade≥3 nausea or vomiting and grade≥4 late esophagitis toxicity in the two groups during chemoradiotherapy;there was no significant difference in the incidence of nausea and vomiting between the two groups;the incidence of late esophagitis toxicity in the experimental group was lower than that in the control group(P<0.05).There were no significant differences in PFS and OS between the two groups.Conclusion GLN supplementation can reduce the occurrence of ARIE and weight loss caused by radiotherapy and chemotherapy in patients with advanced NSCLC,delay the onset of ARIE,and improve the quality of life of patients,which has good clinical value.
作者
黄文创
黄勇
李玉梅
HUANG Wenchuang;HUANG Yong;LI Yumei(Department of Radiology,Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine,Nanning,Guangxi,530000,China)
出处
《当代医学》
2025年第8期148-152,共5页
Contemporary Medicine
关键词
谷氨酰胺
非小细胞肺癌
急性放射性食管炎
放化疗
Glutamine
Non-small cell lung cancer
Acute radiation-induced esophagitis
Chemoradiotherapy
