本研究旨在分析不同营养支持方式对头颈癌（HNC）放疗患者营养状况和免疫功能的影响。HNC患者分为对照（营养咨询和常规膳食指导）、肠外营养(PN)（在对照组之上的PN支持）、肠内营养（EN）（在对照组之上的EN支持）和EN  PN（EN结合PN和常规饮食指导）组。经过营养评估后，四组均接受放疗和营养支持。比较两组患者的体重指数（BMI）、血清白蛋白（ALB）、前白蛋白（PA）、转铁蛋白（TRF）、血红蛋白（Hb）、CD3、CD4、CD8、CD4/CD8、自然杀伤细胞（NK）和生活质量。四组放疗前及放疗后剂量照射完成。评估并记录放疗第2周、第4周及放疗结束时的不良反应发生情况。四组放疗期间均出现一定程度的营养不良，其中EN  PN组营养不良程度最低。放疗剂量照射完成后（T1），PN、EN和EN  PN组的BMI（21.42 ± 1.62、21.40 ± 1.68、22.98 ± 1.87 vs. 20.18 ± 1.32）、血清ALB（31.59 ± ）有所改善3.49, 32.24 ± 4.23 , 37.58 ± 3.23 对比 26.67 ± 3.03), PA (182.63 ± 13.57, 183.43 ± 14.19, 201.59 ± 10.53 对比 165.36 ± 20.13), TRF（162.46±±24.34、157.36±±18.58、182.36±±20.37 与 137.56±±23.19）和 Hb（128.54 ± 9.21、125.36 ± 10.23、140.26 ± 7.23 与 103.24 ± 9.47）水平，较高的 CD3（63.59 ± 2.88、63.25 ± 3.17） , 66.54 ± 1.32 与 59.36 ± 3.24), CD4 (39.92 ± 3.16, 39.87 ± 3.23、43.36 ± 2.87对比37.12 ± 4.29)、CD4/CD8(1.80 ± 0.06、1.78 ± 0.06、2.07 ± 0.03对比1.54 ± 0.10) 和 NK 细胞 (33.87 ± 3.62, 33.26 ± 3.59, 36.82 ± 3.19 vs. 27.36 ± 4.21) 水平，降低 CD8 (22.18 ± 1.07、22.36 ± 1.04、20.46 ± 1.09 vs. 24.09 ± 1.21) 水平，并改善生活质量 (79.97 ± ) 7.96、80.13 ± 7.98、91.78 ± 7.38 71.53±±11.70）与对照组相比，EN  PN组的效果最显着（所有P < 0.05）。放疗期间，放疗不良反应发生率随时间延长而增加（P < 0.05）。PN与EN单独或联合使用，可改善HNC放疗患者的营养状况、免疫功能和生活质量，PN联合应用使用 EN 具有最佳改善效果。© 2024。作者，获得 Federación de Sociedades Españolas de Oncología (FESEO) 的独家许可。

This study aimed to analyze the effects of different nutritional support methods on nutritional status and immune function of patients undergoing radiotherapy for head and neck cancer (HNC).Patients with HNC were divided into the control (nutritional counseling and routine dietary guidance), parenteral nutrition (PN) (PN support on top of the control group), enteral nutrition (EN) (EN support on top of the control group), and EN + PN (EN combined with PN and routine dietary guidance) groups. After nutrition evaluation, the four groups were subjected to radiotherapy and nutritional support. Body mass index (BMI), serum albumin (ALB), prealbumin (PA), transferrin (TRF), hemoglobin (Hb), CD3+, CD4+, CD8+, CD4+/CD8+, natural killer (NK) and quality of life were compared among the four groups before radiotherapy and after radiotherapy dose irradiation completion. The incidence of adverse reactions was assessed and recorded at 2 weeks, 4 weeks and the end of radiotherapy.The four groups experienced some degree of malnutrition during radiotherapy and the EN + PN group possessed the lowest degree of malnutrition. After radiotherapy dose irradiation completion (T1), the PN, EN, and EN + PN groups possessed improved BMI (21.42 ± 1.62, 21.40 ± 1.68, 22.98 ± 1.87 vs. 20.18 ± 1.32), serum ALB (31.59 ± 3.49, 32.24 ± 4.23, 37.58 ± 3.23 vs. 26.67 ± 3.03), PA (182.63 ± 13.57, 183.43 ± 14.19, 201.59 ± 10.53 vs. 165.36 ± 20.13), TRF (162.46 ± 24.34, 157.36 ± 18.58, 182.36 ± 20.37 vs. 137.56 ± 23.19), and Hb (128.54 ± 9.21, 125.36 ± 10.23, 140.26 ± 7.23 vs. 103.24 ± 9.47) levels, higher CD3+ (63.59 ± 2.88, 63.25 ± 3.17, 66.54 ± 1.32 vs. 59.36 ± 3.24), CD4+ (39.92 ± 3.16, 39.87 ± 3.23, 43.36 ± 2.87 vs. 37.12 ± 4.29), CD4+/CD8+ (1.80 ± 0.06, 1.78 ± 0.06, 2.07 ± 0.03 vs. 1.54 ± 0.10) and NK-cells (33.87 ± 3.62, 33.26 ± 3.59, 36.82 ± 3.19 vs. 27.36 ± 4.21) levels, lower CD8+ (22.18 ± 1.07, 22.36 ± 1.04, 20.46 ± 1.09 vs. 24.09 ± 1.21) levels, and improved quality of life (79.97 ± 7.96, 80.13 ± 7.98, 91.78 ± 7.38 vs. 71.53 ± 11.70) versus the control group, and the EN + PN group possessed the most pronounced effects (All P < 0.05). During radiotherapy, the incidence of radiotherapy adverse reactions was increased with time (P < 0.05).PN and EN, alone or in combination, can improve the nutritional status, immune function and quality of life of patients undergoing radiotherapy for HNC, and PN combined with EN has the best improvement effect.© 2024. The Author(s), under exclusive licence to Federación de Sociedades Españolas de Oncología (FESEO).