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| Effect of neoadjuvant chemotherapy combined with nutritional support in patients with primary lung cancer |
| Zhang Li1, Xue Jing2 |
| 1.Department of Physical Examination, Guangyuan Central Hospital, Guangyuan 628000, Sichuan, China；2.Department of Respiratory Medicine, the First Affiliated Hospital of Xian Jiaotong University, Xian 710000, Shaanxi, China |
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Abstract Objective To explore the effect of neoadjuvant chemotherapy (NAC) combined with nutritional support in patients with primary lung cancer, and to provide a reference for its clinical research. Methods Eighty-eight patients diagnosed with primary lung cancer were selected as the research subjects. All patients were treated with NAC. They were divided equally into observation group and control group by random number method. The control group was given conventional diet and the observation group was given nutrition support treatment. The differences in nutritional status (including total protein, albumin, and prealbumin), lung function, and T cell subsets were compared before NAC and after 4 courses of treatment. Results After NAC, the nutrition index level of the control group was lower than that before NAC, and the difference was statistically significant (P<0.05)；the nutrition index of the observation group after NAC was higher than that of the control group (P<0.05). After NAC, FEV1, MVV, V/Q, and RV/TCL in the control group were lower than before NAC (P<0.05)；V/Q and RV/TCL in the observation group after NAC were lower than before NAC (P<0.05)；The FEV1, MVV and V/Q of the group were higher than those of the control group (P<0.05)；the RV/TCL of the observation group after NAC was lower than that of the control group (P<0.05). CD4+/CD8+in the observation group after NAC was lower than before NAC (P<0.05)；CD4+, CD4+/CD8+in the control group after NAC were lower than before NAC (P<0.05)；CD4+, CD4+/CD8+in the observation group after NAC were higher than the control Group (P<0.05). Conclusion Nutritional support can significantly improve the nutritional decline caused by NAC treatment in patients with primary lung cancer, reduce lung function damage caused by chemotherapeutic drugs, and ensure that patients have better immune function, which is worthy of clinical application.
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1.陈万青, 李贺, 孙可欣, 等．2014年中国恶性肿瘤发病和死亡分析［J］．中华肿瘤杂志, 2018, 40(1):5-13．
2.BRODERICK S R. Adjuvant and neoadjuvant immunotherapy in non-small cell lung cancer［J］. Thorac Surg Clin, 2020, 30(2):215-220.
3.BUNN P A Jr, SCHENK E, PACHECO J, et al. New developments in neoadjuvant therapy for lung cancer［J］. Oncology (Williston Park, N.Y.), 2019, 33(3):101-6, 109.
4.IWATA T, TAKEDA Y, IIDA S I, et al. Neoadjuvant chemotherapy and surgery for transdiaphragmatic liver invasion of primary lung cancer［J］.Thoracic cancer, 2013, 4(2):195-197.
5.中华医学会, 中华医学会肿瘤学分会, 中华医学会杂志社. 中华医学会肺癌临床诊疗指南(2018版) ［J］. 肿瘤研究与临床, 2018, 30(12C):793-824.
6.VOGL T J, MEKKAWY A I A, THABET D B, et al. Transvenous pulmonary chemoembolization (TPCE) for palliative or neoadjuvant treatment of lung metastases［J］. Eur Radiol, 2019, 29(4):1939-1949.
7.Pu CY, Yendamuri S. Neoadjuvant versus adjuvant chemotherapy for resectable non-small cell lung cancer debate revisited［J］. J Thorac Dis, 2019, 11(12):5646-5648.
8.SUBRAMANIAN M P, PURI V. Neoadjuvant vs adjuvant chemotherapy in locally advanced non-small cell lung cancer-is timing everything［J］? J Thorac Dis, 2019, 11(12):5674-5676.
9.ZAMORA A K, KIM A W. Driving the discussion about the greater propensity for doing better with neoadjuvant chemotherapy for non-small cell lung cancer［J］. J Thorac Dis, 2019, 11(10):E174-E177.
10.RICE J D, HEIDEL J, TRIVEDI J R, VAN BERKEL V H. Optimal surgical timing after neoadjuvant therapy for stage Ⅲa non-small cell lung cancer［J］. Ann Thorac Surg, 2020, 109(3):842-847.
11.ARSHI J, SAUER M, YIN F. Rapid sarcomatoid transformation of lung squamous cell carcinoma after neoadjuvant therapy: a case report［J］. Anticancer Res, 2020, 40(3):1625-1629.
12.VERSTEGEN N E, MAAT A P, LAGERWAARD F J, et al. Salvage surgery for local failures after stereotactic ablative radiotherapy for early stage non-small cell lung cancer［J］. Radiat Oncol, 2016, 11(1):131.
13.韦巧玲, 庞永慧, 左红群, 等.艾灸联合免疫肠内营养对新辅助化疗胃癌患者营养状况、免疫功能及热休克蛋白70的影响［J］.上海针灸杂志, 2020, 39(5):541-545.
14.宋华, 佟奎鸿. 胃肠内外营养支持联合应用于老年肺癌化疗的效果观察［J］. 中国现代药物应用, 2018, 12(22):18-19.
15.IWATA T, TAKEDA Y, IIDA S I, et al. Neoadjuvant chemotherapy and surgery for transdiaphragmatic liver invasion of primary lung cancer［J］. Thoracic Cancer, 2013, 4(2):195-197.
16.NAGATA K, TSUJIMOTO H, NAGATA H, et al. Nutritional benefit of laparoscopic jejunostomy during neoadjuvant chemotherapy for obstructing esophageal cancer［J］. Mol Clin Oncol, 2019, 11(6): 612-616.
17.SHINDE A, HORNE Z D, LI R, et al. Optimal adjuvant therapy in clinically N2 non-small cell lung cancer patients undergoing neoadjuvant chemotherapy and surgery: the importance of pathological response and lymph node ratio［J］. Lung Cancer, 2019, 133:136-143.
18.SANUSI R S. Outcome of combined neoadjuvant chemotherapy and vitamin a in advanced cervical carcinoma: a randomized double-blind clinical Trial［J］. Asian Pac J Cancer Prev, 2019, 20(7):2213-2218.
19.TAO X, YUAN C, ZHENG D, et al. Outcomes comparison between neoadjuvant chemotherapy and adjuvant chemotherapy in stage ⅢA non-small cell lung cancer patients［J］. J Thorac Dis, 2019, 11(4):1443-1455.
20.NAGASAKA M, GADGEEL S M. Role of chemotherapy and targeted therapy in early-stage non-small cell lung cancer［J］. Expert Rev Anticancer Ther, 2018, 18(1):63-70.
21.刘金锋, 田惠玉, 孙会凤, 等. 营养支持对非小细胞肺癌患者术前新辅助化疗后肺功能的影响［J］. 临床荟萃, 2014, 29(5):518-520.
22.冯晓飞, 杨哲, 索凤茹, 等. 十全大补汤联合常规早期肠内营养对肺癌切除术后患者免疫功能及临床疗效的影响［J］. 世界中医药, 2019, 14(9): 2379-2382.
23.付国霞. 胃肠内外联合营养支持对老年肺癌患者化疗后营养状况和免疫功能的影响［J］. 饮食保健, 2019, 6(14):24-25.
24.KUMAR A, TORRES M L, CLIBY W A, et al. Inflammatory and nutritional serum markers as predictors of peri-operative morbidity and survival in ovarian cancer［J］. Anticancer Res, 2017, 37(7):3673-3677.
25.蒋庆锋, 马东阳, 程金华, 等. 小柴胡汤对肺癌晚期患者生命质量、免疫能力及炎性反应效应的影响［J］. 世界中医药, 2019, 14(4): 982-987.
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