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Effect of nutritional status on clinical outcomes and adverse effects of patients with concurrent radiochemotherapy for cervical cancer and associated cost-benefit analysis

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Journal Title:
Chinese Journal of Health Management
Key Word:
宫颈癌;同步放化疗;营养状态;副反应;成本效果分析;Uterine cervical neoplasms;Chemoradiotherapy;Nutritional status;Adverse effects;Cost-benefit analysis

Abstract´╝Ü Objective:To explore the effect of the nutritional status on the clinical outcome and adverse effects of patients with concurrent radiochemotherapy for cervical cancer and analyze the cost-effectiveness of this treatment.Method:This study is a prospective, observational cohort study continuously enrolling patients with cervical cancer who received concurrent radiochemotherapy from 2018-05-01 to 2018-09-01 in Peking Union Medical College Hospital. According to the criteria, patients were divided into two groups: nutritional disorders and normal nutrition groups. There were 81 and 94 cases of abnormal and normal nutrition, respectively. Blood tests, liver function tests, treatment costs for adverse effects, and nutritional support were employed. We observed the incidence of vomiting, diarrhea, bone marrow suppression, infection, and other responses in the two groups, followed by clinical outcomes and the cost-effectiveness analysis.Results:Compared with the normal nutrition group, the infection rate (27.2% vs 14.9%, χ 2=4.007, P=0.045), the incidence of bone marrow suppression (86.4% vs 69.1%, χ 2=7.36, P= 0.007), the cost of bone marrow suppression treatment [324.0 (164.2-648.0) vs 587.8 (243.6-1 728.0), z=2.698, P=0.007), and the treatment cost [71.4 (45.2-123.7) vs 85.1 (57.0-198.9), z=1.994, P=0.030) significantly increased in the nutritional disorder group. There were more patients with poor clinical outcomes in the nutritional disorder group than in the normal group (29.6% vs 8.5%, χ 2= 12.987, P<0.001). Only 7.2% of the patients had visited a nutrition clinic, and the rate of nutrition intervention was extremely low. Conclusion:In patients with cervical cancer undergoing concurrent radiochemotherapy, there is a higher incidence of adverse effects, such as infection and bone marrow suppression, as well as higher treatment costs and worse clinical outcomes.

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