高用量シスプラチンを用いた化学放射線同時併用療法における栄養状態の変化に関する検討<br>～特に放射線単独療法との違いについて～

DOI Web Site 被引用文献1件 参考文献33件
  • 中原 晋
    大阪府立成人病センター耳鼻咽喉科・頭頸部外科 大阪大学大学院医学系研究科耳鼻咽喉科・頭頸部外科学
  • 吉野 邦俊
    大阪府立成人病センター耳鼻咽喉科・頭頸部外科
  • 藤井 隆
    大阪府立成人病センター耳鼻咽喉科・頭頸部外科
  • 上村 裕和
    大阪府立成人病センター耳鼻咽喉科・頭頸部外科
  • 鈴木 基之
    大阪府立成人病センター耳鼻咽喉科・頭頸部外科
  • 西山 謹司
    大阪府立成人病センター放射線治療科
  • 猪原 秀典
    大阪大学大学院医学系研究科耳鼻咽喉科・頭頸部外科学

書誌事項

タイトル別名
  • Nutritional Surveillance in Head and Neck Cancer Patients during Radiotherapy<br>—the Difference between Concurrent Chemoradiotherapy using High-dose Cisplatin and Radiotherapy alone—
  • コウヨウリョウ シスプラチン オ モチイタ カガク ホウシャセン ドウジ ヘイヨウ リョウホウ ニ オケル エイヨウ ジョウタイ ノ ヘンカ ニ カンスル ケントウ : トクニ ホウシャセン タンドク リョウホウ ト ノ チガイ ニ ツイテ

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抄録

Concurrent chemoradiotherapy (CCRT) has been widely used in organ preservation for advanced head and neck squamous cell carcinoma. Malnutrition, one of the most detrimental side effects concerned with CCRT, occurs frequently in patients with CCRT, but few studies have reported on the nutritional status in detail during CCRT. The aim of this study was to evaluate the changes in the nutritional status during CCRT compared with radiotherapy alone (RT). We introduce hypopharyngeal cancer patients as the subjects that include 26 cases who underwent CCRT with high dose cisplatin (80mg/m2×3: goal 240mg/m2 in total) and also 26 cases who underwent RT during the same period. For evaluation, we examined the rate of body weight change, serum albumin, total lymphocyte counts and hemoglobin. In this context, the rate of body weight change is the most reliable indicator, and the rate of change at the end of treatment as compared to before the start of treatment was 3.8% in patients treated with RT and 8.1% in patients treated with CCRT. This result suggests that improvement in nutritional status is necessary when considering patients undergoing CCRT. However, regarding completion of treatment, when radiotherapy was not interrupted due to adverse events the median total dose of cisplatin of 240 mg/m2 seemed satisfactory. In addition, regarding the route for energy intake, tube feeding was required only in 2 patients (7.7%) in the RT group and 4 patients (15.4%) in the CCRT group, and no significant difference was found between them. Therefore, percutaneous endoscopic gastrostomy (PEG) for CCRT in advance would be unnecessary at least for hypopharyngeal cancer patients.

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