关键词: 宫颈癌, 同步放射和化学治疗, 基线营养状态, 慢性放射治疗不良反应, 营养风险筛查

Abstract: Objective To investigate the relationship between baseline nutritional status and chronic radiotherapy-induced adverse effects in cervical cancer patients after radiotherapy. Methods A total of 109 previously untreated cervical cancer patients undergoing definitive concurrent chemoradiotherapy were prospectively enrolled. Baseline nutritional status was evaluated by Nutritional Risk Screening 2002( NRS 2002),body mass index(BMI), skeletal muscle index, body fat percentage and visceral fat area. The incidence and severity of chronic radiation enteritis, cystitis and hematological toxicity were recorded during follow-up. Univariate and multivariate Logistic regression were used for statistical analysis. Results The incidence of chronic radiation enteritis, cystitis and hematological toxicity was 37.6%, 24.8% and 42.2%, respectively. Baseline nutritional risk was an independent risk factor for chronic radiation enteritis (OR=2.77, 95% CI: 1.19-6.42, P=0.016). Higher NRS scores were associated with chronic hematological toxicity. No significant correlation was found between nutritional indicators and radiation cystitis. BMI, wasting and low muscle mass were not independently associated with chronic adverse effects. Conclusions Baseline nutritional risk and elevated NRS scores significantly increase the risk of chronic radiation enteritis and hematological toxicity in cervical cancer patients after radiotherapy. Routine nutritional screening and early intervention before radiotherapy may reduce long-term chronic radiation injury.

Key words: cervical cancer, concurrent chemoradiotherapy, baseline nutritional status, chronic radiotheray-induced adverse effect, nutritional Risk Screening