Application of nutritional status assessment in chemotherapy tolerance of patients after total gastrectomy
Objective To explore the application of nutritional status assessment in chemotherapy tolerance of patients after total gastrectomy.Method 154 gastric cancer patients who received radical total Gastrectomy and postoperative chemotherapy from March 2018 to February 2022 in Beijing Luhe Hospital Capital Medical University were included as the study subjects.According to whether the patients stopped chemotherapy within 6 months after surgery,they were divided into tolerance group(n=122)and intolerance group(n=32).Kaplan Meier curve was used to analyze the relationship between the stratification of chemotherapy duration and the survival rate of patients after total gastrectomy,Single factor logistic regression was used to analyze the influencing factors of chemotherapy tolerance in patients after total gastrectomy,and Receiver operating characteristic was drawn to analyze the predictive value of related factors.Result Kaplan Meier survival curve analysis showed that chemotherapy tolerance of patients after total gastrectomy was related to overall survival rate[Log Rank(Mantel Cox)=11.017,P=0.001].Age,basic diseases,nutritional risk screening 2002(NRS 2002),prognostic nutritional index(PNI),carcinoembryonic antigen(CEA),albumin(ALB)and hemoglobin(Hb)of the patients in the two groups.The variables in univariate analysis(P＜0.05)were included in multivariate Logistic regression model,and the results showed that age(OR=6.150),PNI(OR=3.263),Hb(OR=1.090)and ALB(OR=1.342)were the independent risk factors of chemotherapy tolerance of patients after total gastrectomy(P＜0.05).The ROC curve shows that the area under the curve(AUC)of age is 0.694(95％CI=0.615-0.766),that of PNI is 0.774(95％CI=0.700-0.838),that of Hb is 0.893(95％CI=0.833-0.937),and that of ALB is 0.814(95％CI=0.743-0.872).Conclusion Older age,low prognostic nutritional index and low levels of hemoglobin and albumin are risk factors for chemotherapy tolerance in patients after total gastrectomy,among which hemoglobin and albumin levels have significant predictive efficacy on chemotherapy tolerance of patients after total gastrectomy,and need to be used as predictive indicators for postoperative chemotherapy tolerance of patients with gastric cancer.
Radical total gastrectomyChemotherapy toleranceBody mass indexPrognostic nutritional index
万方数据
维普
