Early intervention with supplemental parenteral nutrition reduces the incidence of granulocytopenia-related infections in patients with lung cancer: a retrospective cohort study

Xiaoguang Qi ； Chunyan Qi ； Tao Wu ； Boyu Qin ； Yi Hu

《Asia Pacific Journal of Clinical Nutrition》 28卷4期 (2019/12) Pp. 711-719

https://doi.org/10.6133/apjcn.201912_28(4).0006

摘要

Background and Objectives: The optimal timing for initiating supplemental parenteral nutrition in chemotherapy-induced severe granulocytopenia in patients with lung cancer remains uncertain. Methods and Study Design: A retrospective study was conducted among patients with lung cancer from February 2016 to June 2018. In total, 182 eligible patients were included and divided into 2 groups according to the time of supplemental parenteral nutrition intervention: early initiation (within 72 hours of development of granulocytopenia) and late initiation (over 72 hours). The primary outcomes of the study were bacterial infection and fungal infection, and the secondary outcomes were duration of absolute neutrophil count less than 1.0×10^9 cells/L, length of hospital stay, mortality rate, and rate of chemotherapy (4 cycles) completion. Results: The incidence rates of bacterial infection and fungal infection were significantly lower among patients who received supplemental parenteral nutrition early than among patients who received it late. No significant difference in mortality was observed between the groups. In addition, compared with late supplemental parenteral nutrition, early supplemental parenteral nutrition was associated with a higher rate of completion of 4 chemotherapy cycles and shorter hospital stays and leukocyte recovery periods in our cohort. Univariate and multivariate logistic regression analyses revealed that the subgroup of patients with an NRS-2002 score of 2 benefited from early supplemental parenteral nutrition. Conclusions: Early supplemental parenteral nutrition after chemotherapy-induced severe granulocytopenia could reduce the risk of infection, improve the likelihood of chemotherapy completion, and shorten hospital stays and leukocyte recovery times.

關鍵字

myelosuppression ； supplemental parenteral nutrition ； granulocytopenia ； chemotherapy ； lung cancer