Objective  To analyze the effect of five-step nutrition and CAPEOX chemotherapy as adjuvant chemotherapy for colorectal cancer (CRC).

Methods  82 CRC postoperative adjuvant chemotherapy patients admitted from October 2020 to October 2022 were selected by random num-bers method, and the enrolled patients underwent CAPEOX chemotherapy. If gastrointestinal reaction occurred during chemotherapy, antiemesis, stomach protection and appetite improvement should be given; On this basis, the control group (n=41) was treated with conventional nutrition therapy, and the study group (n=41) was treated with five-step nutrition therapy, chemotherapy status, nutritional status, tumor markers and bone marrow suppression of the two groups were compared.

Results  The study group completed more chemotherapy cycles than the control group (P<0.001). After the last chemotherapy, the levels of albumin (ALB), prealbumin (PA), and transferrin (TRF) in the study group were higher than those in the control group (P<0.001), and the patient-generated subjective global assessment (PG-SGA) score was lower than that in the control group (P<0.001); study group had lower carbohydrate antigen 199 (CA199) and carcinoembryonic antigen (CEA) levels than the control group (P<0.001); leukocyte and granulocyte suppression rate (48.78% vs. 70.73%, P<0.05; 60.98% vs. 82.93%, P<0.05) in study group were lower than those in the control group.

Conclusion  Five-step nutrition combined with CAPEOX chemotherapy in patients with adjuvant chemotherapy after CRC is beneficial to improve their nutritional status.

1.邱丹, 吕杨波, 陈震宏. 五阶梯营养治疗对结直肠癌患者术后辅助化疗所致骨髓抑制的作用[J]. 浙江医学, 2021, 43(5): 497-501. [Qiu D, Lyu YB, Chen ZH. Five-step nutrition therapy alleviates bone marrow suppression caused by postoperative adjuvant chemotherapy in patients with colorectal cancer[J]. Zhejiang Medical Journal, 2021, 43(5): 497-501.] DOI: 10.12056/j.issn.1006-2785.2021.43.5.2020-3047.

2.张盼盼, 王朝阳, 郭振, 等. 五阶梯营养方案对结直肠癌术后辅助化疗患者营养状态的影响[J]. 临床护理杂志, 2022, 21(3): 8-11. [Zhang PP, Wang CY, Guo Z, et al. Effects of five-step nutrition regimen on nutritional status of postoperative adjuvant chemotherapy patients with colorectal cancer[J]. Journal of Clinical Nursing, 2022, 21(3): 8-11.] DOI: 10.3969/j.issn.1671-8933.2022.03.003.

3.李权, 冷蔚, 李由, 等. Capeox方案、mFOLFOX6方案化疗致结直肠癌患者心脏毒性的临床研究[J]. 现代医药卫生, 2022, 38(7): 1205-1208. [Li Q, Leng W, Li Y, et al. Clinical study of cardiotoxicity in patients with colorectal cancer caused by chemo-therapy with Capex regimen and mFOLFOX6 regimen[J]. Journal of Modern Medicine & Health, 2022, 38(7): 1205-1208.] DOI: 10.3969/j.issn.1009-5519.2022.07.029.

4.杨洋, 赵勇. 丙氨酰谷氨酰胺及双歧杆菌三联活菌胶囊在结直肠癌术后辅助化疗中对肠道屏障功能的影响[J]. 中国现代医学杂志, 2020, 30(15): 79-84. [Yang Y, Zhao Y. Effect of alanyl glutamine and bifidobacterium triple viable capsule on intestinal barrier function in postoperative adjuvant chemotherapy for colorectal cancer[J]. China Journal of Modern Medicine, 2020, 30(15): 79-84.] DOI: 10.3969/j.issn.1005-8982.2020.15.015.

5.刘丽, 谭光根, 武昱, 等. S-1与卡培他滨分别联合奥沙利铂治疗晚期结直肠癌的临床疗效研究[J]. 肿瘤药学, 2017, 7(3): 309-314. [Liu L, Tan GG, Wu Y, et al. A clinical study on the efficacy of S-1 plus oxaliplatin versus capecitabine plus oxaliplatin for patients with advanced colorectal cancer[J]. Anti-Tumor Pharmacy, 2017, 7(3): 309-314.] DOI: 10.3969/j.issn.2095-1264.2017.03.11.

6.秦舟, 占美, 何治尧, 等. SOX方案对比CapeOX方案治疗转移性结直肠癌的成本-效果分析[J]. 中国药房, 2018, 29(6): 779-783. [Qin Z, Zhan M, He ZY, et al. Cost-effectiveness analysis of SOX regimen versus CapeOX regimen for metastatic colorectal cancer[J]. China Pharmacy, 2018, 29(6): 779-783.] DOI: 10.6039/j.issn.1001-0408.2018.06.14.

7.井小会, 郭运杰. 贝伐单抗联合CapeOx用于转移性结直肠癌转换化疗的临床研究[J]. 中国医师杂志, 2012, 14(10): 1404-1407. [Jing XH, Guo YJ. Clinical study of bevacizumab combined with CapeOx for conversion chemotherapy of metastatic colorectal cancer[J]. Journal of Chinese Physician, 2012, 14(10): 1404-1407.] DOI: 10.3760/cma.j.issn.1008-1372.2012.10.036.

8.中华医学会消化内镜学分会, 中国抗癌协会肿瘤内镜学专业委员会. 中国早期结直肠癌筛查及内镜诊治指南(2014,北京)[J]. 中华医学杂志, 2015, 95(28): 2235-2252. [Digestive Endoscopy Branch of Chinese Medical Association, Cancer Endoscopy Professional Committee of China Anti Cancer Association. Guidelines for screening and endoscopic diagnosis and treatment of early colorectal cancer in China (2014, Beijing)[J]. National Medical Journal of China, 2015, 95(28): 2235-2252.] DOI: 10.3760/cma.j.issn.0376-2491.2015.28.002.

9.刘荫华, 姚宏伟, 周斌, 等. 美国肿瘤联合会结直肠癌分期系统(第8版)更新解读[J]. 中国实用外科杂志, 2017, 37(1): 6-9. [Liu YH, Yao HW, Zhou B, et al. Updates and interpretations of AJCC Cancer Staging Manual 8th edition for colorectal car-cinoma[J]. Chinese Journal of Practical Surgery, 2017, 37(1): 6-9.] DOI: 10.19538/j.cjps.issn1005-2208.2017.01.03.

10.张逖, 王泰岳, 陈剑, 等. 雷替曲塞术中腹腔灌注联合奥沙利铂联合卡培他滨方案治疗Ⅲ期结直肠癌患者的临床研究[J]. 山西医药杂志, 2018, 47(23): 2833-2835. [Zhang T, Wang TY, Chen J, et al. Clinical study on the treatment of patients with stage III colorectal cancer by intraperitoneal perfusion of retetraxel combined with ox-aliplatin and capecitabine[J]. Shanxi Medical Journal, 2018, 47(23): 2833-2835.] DOI: 10.3969/j.issn.0253-9926.2018.23.021.

11.徐蓉, 马楠, 罗健, 等. KRAS、FCGR、CYP3A5与CYP1A1检测对转移性结直肠癌化学靶向药物临床疗效预测作用的研究[J]. 中国医师杂志, 2017, 19(11): 1649-1653, 1657. [Xu R, Ma N, Luo J, et al. Study of genetic detection of KRAS, FCGR, CYP3A5 and CYP1A1 in predicting clinical outcomes of chemotherapy/target therapy in metastatic colorectal cancer (mCRC)[J]. Journal of Chinese Physician, 2017, 19(11): 1649-1653, 1657.] DOI: 10.3760/cma.j.issn.1008-1372.2017.11.012.

12.谌步云, 吴杏梅, 张鸿光, 等. 早期肠内-肠外联合营养对老年结直肠癌患者术后营养状况及免疫功能的影响[J]. 浙江医学, 2019, 41(2): 150-153. [Chen BY, Wu XM, Zhang HG, et al. Impact of early enteral combined with parenteral nutri-tion on postoperative nutritional status and immune function in elderly patients with colorectal cancer[J]. Zhejiang Med-ical Journal, 2019, 41(2): 150-153.] DOI: 10.12056/j.issn.1006-2785.2019.41.2.2017-1240.

13.李戆智, 张雪, 刘畅. 早期肠内外营养支持护理对老年结直肠癌患者术后营养状况及康复效果的影响[J]. 中国肿瘤临床与康复, 2020, 27(3): 371-373. [Li GZ, Zhang X, Liu C. Effect of early enteral and parenteral nutrition support on nutritional status and rehabilitation effectiveness in elderly patients with colorectal cancer after surgery[J]. Chinese Journal of Clinical Oncology and Rehabilitation, 2020, 27(3): 371-373.] DOI: 10.13455/j.cnki.cjcor.2020.03.30.

14.王勇, 余应筠, 郑祖文, 等. 腹腔镜辅助结直肠癌根治术治疗结直肠癌的疗效及对患者营养水平、机体免疫状态的影响[J]. 癌症进展, 2019, 17(5): 595-598. [Wang Y, Yu YJ, Zheng ZW, et al. Clinical effects of laparosco-py-assisted radical resection of colorectal cancer and its effect on nutritional level and immune status of patients[J]. Oncology Progress, 2019, 17(5): 595-598.] DOI: 10.11877/j.issn.1672-1535.2019.17.05.27.

15.张晓峰, 冯景, 季飞燕, 等. 结直肠癌术后辅助化疗患者肠内营养不耐受影响因素及小野寺预后营养指数预测价值分析[J]. 陕西医学杂志, 2022, 51(9): 1114-1117, 1121. [Zhang XF, Feng J, Ji FY, et al. Analysis of the influence factors of enteral nutrition intolerance and the predictive value of the nutritional index of the prognosis of Onoshi in patients with colorectal cancer after adjuvant chemotherapy[J]. Shaanxi Medical Journal, 2022, 51(9): 1114-1117, 1121.] DOI: 10.3969/j.issn.1000-7377.2022.09.016.

16.费伯健, 潘菊萍, 吴浩荣, 等. 术前营养风险筛查对结直肠癌患者围手术期营养支持治疗的临床意义[J]. 中华胃肠外科杂志, 2014, (6): 582-585. [Fei BJ, Pan JP, Wu HR, et al. Application of preoperative nutritional risk screening in perioperative nutrition support for colorectal cancer patients[J]. Chinese Journal of Gas-trointestinal Surgery, 2014, (6): 582-585.] DOI: 10.3760/cma.j.issn.1671-0274.2014.06.015.

17.匡荣康, 王成龙, 强光辉, 等. 营养状态对结直肠癌病人手术部位感染的影响及相关因素分析[J]. 肠外与肠内营养, 2021, 28(2): 84-87. [Kuang RK, Wang CL, Qiang GH, et al. Analysis of the influencing factors for SSI in colorectal cancer patients with different nutrition disorder[J]. Parenteral & Enteral Nutrition, 2021, 28(2): 84-87.] DOI: 10.16151/j.1007-810x.2021.02.005.

18.庄惠杰, 拾锦. 围手术期不同营养干预方案对结直肠癌患者术后营养状态、免疫状况及并发症的影响[J]. 中国医学创新, 2022, 19(16): 149-153. [Zhuang HJ, Shi J. Effects of different perioperative nutritional intervention schemes on postoperative nutritional status, immune status and complications in patients with colorectal cancer[J]. Medical Innovation of China, 2022, 19(16): 149-153.] DOI: 10.3969/j.issn.1674-4985.2022.16.036.

19.钟明霞, 傅聿铭, 吴万庆, 等. 早期肠内营养对结肠癌根治术后患者营养状态及消化道功能恢复的影响[J]. 癌症进展, 2020, 18(3): 317-320. [Zhong MX, Fu YM, Wu WQ, et al. The effect of early enteral nutrition on the nutritional status and recovery of gastrointestinal tract function in patients with radical colectomy[J]. Oncology Progress, 2020, 18(3): 317-320.] DOI: 10.11877/j.issn.1672-1535.2020.18.03.28.

20.张玉峰, 王皇建, 李朝辉, 等. 结直肠癌患者术后感染危险因素及早期营养指标与炎症因子水平变化的临床预测价值[J]. 中国老年学杂志, 2021, 41(4): 749-752. [Zhang YF, Wang HJ, Li ZH, et al. Clinical predictive value of postoperative infection risk factors and changes of early nutritional indicators and inflammatory factors in patients with colorectal cancer[J]. Chinese Journal of Gerontology, 2021, 41(4): 749-752.] DOI: 10.3969/j.issn.1005-9202.2021.04.025.