Objective: To investigate the effect of nutritional risk screening tool (NRS-2002) upon the clinical efficacy and survival outcomes in patients with unresectable locally advanced esophageal squamous cell carcinoma (LAESCC) receiving concurrent chemoradiotherapy. Methods: Clinical data of 105 LAESCC patients treated with concurrent chemoradiotherapy in Zhejiang Provincial People′s Hospital from January 2013 to December 2015 were retrospectively analyzed. Nutritional status screening was performed using the NRS-2002 scale. The rate comparison was analyzed by using chi-square test. Kaplan-Meier survival analysis was adopted to calculate the survival rate. Log-rank test was utilized to statistically analyze the differences in survival outcomes. Cox regression model was used for uni-and multi-variate analyses. Results: Prior to concurrent chemoradiotherapy, 37.1% of patients had the nutritional risk. Patients with NRS-2002 score ≥3 had a significantly higher incidence of ≥ grade 3 toxic reactions compared with their counterparts obtaining NRS-2002 score of 1-2(P=0.007). The median overall survival (OS) and progression-free survival (PFS) of all patients were 17.0 and 11.8 months. The OS and PFS of patients with NRS-2002 score ≥ 3 were significantly lower than those of their counterparts obtaining NRS-2002 score of 1-2(both P=0.000). Multivariate analysis demonstrated that NRS-2002 score of ≥3 was an independent prognostic factor for OS (P=0.000) and PFS (P=0.001). Conclusions NRS-2002 tool reveals that patients with esophageal cancer possess a relatively high nutritional risk. Prior to treatment, NRS-2002 score of ≥3 is significantly correlated with an increasing risk of toxic reactions and decreasing survival rate, which is worthy of subsequent investigation.

BACKGROUND/AIMS: There are increasing evidences for gastrointestinal motility disorder (GIMD) and gastric stress ulcer induced by noise stress. The present study was to investigate the reversed effect of melatonin on GIMD and gastric stress ulcer induced by noise stress and potential mechanism. METHODS: Noise stress was induced on rats, and melatonin (15 mg/kg) was administered to rats by intraperitoneal injection. Differences were assessed in gastric residual rate (GRR), small intestine propulsion rate (SPR), Guth injury score, cortisol, gastrointestinal hormones (calcitonin-gene-related peptide and motilin) and oxidative stress markers (superoxide dismutase and malondialde hyde) in blood plasma as well as gastric mucosa homogenate with or without melatonin. The pathological examination of gastric mucosa was also performed. RESULTS: The GRR and SPR were improved by noise stress compared with control (P < 0.05). The pathological examination and Guth injury score revealed gastric stress ulcer. Moreover, the levels of cortisol, motilin and malondialdehyde in blood plasma and malondialdehyde in gastric mucosa homogenate were increased by noise stress (P < 0.05). CGRP and superoxide dismutase activity in both of blood plasma and gastric mucosa homogenate were significantly decreased (P< 0.05). Furthermore, melatonin reversed changes in GRR, SPR, pathological examination, Guth injury score, cortisol, motilin, CGRP, superoxide dismutase activity and malondialdehyde (P < 0.05). CONCLUSIONS: Melatonin is effective in reversing the GIMD and gastric stress ulcer induced by noise stress. The underlying mechanism may be involved in oxidative stress and gastrointestinal hormones.
Animals ; Gastric Mucosa ; Gastrointestinal Hormones* ; Gastrointestinal Motility* ; Hydrocortisone ; Injections, Intraperitoneal ; Intestine, Small ; Malondialdehyde ; Melatonin* ; Motilin ; Noise* ; Oxidative Stress* ; Plasma ; Rats* ; Superoxide Dismutase ; Ulcer*