INTRODUCTION:Significant malnutrition exists in a high percentage of patients with head and neck cancer. Malnutrition is associated with defects in immune function that may impair the host response to malignancy. Malnutrition and immunosupression make patients highly susceptible to postoperative infections and complications. OBJECTIVES:Some studies of patients receiving immuno-nutrition in the perioperative period in head and neck cancer have shown beneficial effects on clinical outcome and inmune status. The authors carried out a systematic review of randomised control trials to determine whether perioperative immunonutrition has a role in the treatment of head and neck cancer. METHODS:14 trials of polymeric nutritional supplementation with immunonutrition were identified. Two studies compared two types of immunonutrition. RESULTS:A reduction in the length of postoperative hospital stay was seen in some trials, but the reason for this reduction is not clear. Some studides showed statistical differences with less complications in arginine-enhanced group and also showed a significant decrease of fistula complications in patients treated with a high arginine dose enhanced formula, if compared with a medium dose of arginine. CONCLUSION:[corrected] Those planning future studies face challenges. A suitable powered clinical trial is required before firm recommendations can be made on the use of immunonutrition in head and neck cancer patients postoperatively.

译文

简介:大量的营养不良存在于头颈癌患者中。营养不良与免疫功能缺陷有关,可能损害宿主对恶性肿瘤的反应。营养不良和免疫抑制使患者对术后感染和并发症高度敏感。
目的:一些对头颈部癌患者围手术期接受免疫营养治疗的患者的研究表明,其对临床结局和免疫状况具有有益作用。作者对随机对照试验进行了系统评价,以确定围手术期免疫营养是否在头颈癌的治疗中起作用。
方法:鉴定了14项免疫营养性高分子营养补充试验。两项研究比较了两种类型的免疫营养。
结果:在某些试验中,术后住院时间减少了,但是减少的原因尚不清楚。与中等剂量的精氨酸相比,精氨酸增强组的某些研究结果显示统计学差异且并发症较少,并且用高精氨酸剂量增强配方治疗的患者的瘘管并发症也显着减少。
结论:[已纠正]那些计划未来研究的人面临挑战。在对头颈癌患者术后使用免疫营养提出确切建议之前,需要进行适当的临床试验。

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