Oiginal Article
Effects of proton and heavy ion radiotherapy on nutritional status and adverse events in patients with malignant tumor
Chen Shengfang, Shao Jian, Li Mo, Du Ning
Published 2022-12-30
Cite as Chin J Clin Nutr, 2022, 30(6): 367-373. DOI: 10.3760/cma.j.cn115822-20220611-00108
Abstract
ObjectiveTo understand the effects of proton and heavy ion radiotherapy on nutritional status in patients with malignant tumors and to analyze the influencing factors of adverse events.
MethodsPatients with malignant tumors who received proton and heavy ion therapy between October 2016 and September 2021were retrospectively included. The demographic characteristics, clinical diagnosis, radiotherapy regimen, nutritional indicators and adverse events were collected. Paired t test was used to analyze the changes in nutritional status before and after treatment and logistic regression was used to analyze the influencing factors of adverse events.
ResultsA total of 2,390 patients were enrolled and were stratified into 4 groups according to different radiotherapy regimen, namely proton, heavy ion, proton + heavy ion and photon + heavy ion radiotherapies. The prevalence of nutritional risk were 17.5% and 27.8% at admission and discharge, respectively. The prevalence of nutritional risk at discharge were 73.9% (χ2 = 237.149, P < 0.01) in patients who received photon + heavy ion radiotherapy and 30.8% (χ2 = 36.925, P < 0.01) in those who received proton + heavy ion radiotherapy. The prevalence of critical weight loss at discharge was 14.1%, with the absolute weight loss of 4.84 kg (t = 11.716, P < 0.01) and 1.52 kg (t = 29.530, P < 0.01) in photon + heavy ion radiotherapy and proton + heavy ion radiotherapy groups, respectively. All groups showed significant changes in serum albumin (ALB) and total lymphocyte count (TLC). Specifically, photon + heavy ion and proton + heavy ion therapy had a greater effect on serum ALB and TLC, with a decrease of 2.88 g/L and 2.18 g/L for ALB as well as a decrease of (1.06×109) /L and (0.80×109) /L for TLC (P < 0.01). Multivariate logistic regression analysis showed that nutritional risk at admission and concurrent chemotherapy were independent factors for adverse events of proton and heavy ion radiotherapy (OR = 1.404, 95%CI: 1.039 to 1.898; OR = 2.370, 95%CI: 1.781 to 3.154). Compared with heavy ion radiotherapy, the other 3 groups had more adverse events (proton, OR = 3.982, 95%CI: 2.533 to 6.259; proton + heavy ion, OR = 4.995, 95%CI: 3.688 to 6.766; photon + heavy ion, OR = 7.716, 95%CI: 5.079 to 11.720).
ConclusionsPatients receiving proton and heavy ion therapy showed poorer nutritional status. Photon + heavy ion therapy had the greatest impact on nutritional status. Nutritional risk at admission and concurrent chemotherapy were independent factors for adverse events in patients receiving proton and heavy ion therapy.
Key words:
Proton and heavy ion; Nutritional risk; Critical weight loss; Lymphocyte count; Adverse event
Contributor Information
Chen Shengfang
Deparment of Clinical Nutrition, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
Shao Jian
Medical Department, Shanghai Proton and Heavy Ion Center, Shanghai 201315, China
Shanghai Key Laboratory of Radiation Oncology, Shanghai 201315, China
Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai 201315, China
Li Mo
Medical Department, Shanghai Proton and Heavy Ion Center, Shanghai 201315, China
Shanghai Key Laboratory of Radiation Oncology, Shanghai 201315, China
Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai 201315, China
Du Ning
Medical Department, Shanghai Proton and Heavy Ion Center, Shanghai 201315, China
Shanghai Key Laboratory of Radiation Oncology, Shanghai 201315, China
Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai 201315, China
