营养治疗不能提高肿瘤治疗的疗效

Q4 Medicine
Nowotwory Pub Date : 2018-02-22 DOI:10.5603/NJO.2017.0051
A. Kapała
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引用次数: 2

摘要

营养治疗在肿瘤治疗的多个方面的有益作用主要体现在预防和治疗伴随癌症疾病的消耗综合征和癌症恶病质。开始治疗前消瘦综合征的存在与并发症发生时间较短、总生存期(OS)较短、肿瘤治疗反应较差、生活质量恶化、一般状况较差相关;此外,恶病质强烈影响治疗耐受性。临床营养是支持肿瘤治疗的最重要支柱之一,然而,人们必须注意某些情况下,营养干预,特别是肠外营养,不能带来好处,甚至可能对患者有害。这类病例包括:对体重正常且胃肠道功能正常的患者进行肠外营养;低白蛋白血症引起的PN,可能通过胃肠道喂养的患者(口服或肠内);病毒质患者开始PN或EN时缺乏再喂养综合征预防;使用只含大豆油作为唯一脂肪营养素的饲料混合物;营养不全(仅宏量营养素或微量营养素);在接受持续营养治疗的晚期癌症患者中纳入PN。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Nutrition treatment does not improve the efficacy of oncological treatment
A beneficial effect of nutrition treatment on multiple aspects of oncological therapy is chiefly demonstrated by pre­venting and in treating the wasting syndrome and cancer cachexia accompanying the cancer disease. The presence of the wasting syndrome prior to commencing treatment is associated with shorter time for developing complications along with a shorter overall survival (OS), worse response to oncological treatment, deteriorating quality of life, poorer general status; moreover, cachexia strongly affects treatment tolerance. Clinical nutrition is one of the most significant pillars supporting oncological treatment, nonetheless, one has to be mindful of certain cases where nutritional inte­rvention, especially parenteral nutrition, does not bring benefits, and may even be harmful to the patient. Such cases include: PN (parenteral nutrition) for patients with normal body mass and a correctly functioning gastrointestinal tract; PN due to hypoalbuminemia, in patients where feeding via the gastrointestinal tract is possible (orally or enterally); lack of refeeding syndrome prevention for cachectic patients starting PN or EN; use of feeding mixtures containing only soya oil as the sole fatty nutrient; incomplete nutrition (macronutrients or micronutrients only); inclusion of PN in patients in the terminal phase of cancer undergoing persistent nutrition therapy.
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来源期刊
Nowotwory
Nowotwory Medicine-Oncology
CiteScore
0.90
自引率
0.00%
发文量
44
期刊介绍: NOWOTWORY Journal of Oncology publishes papers which cover all aspects of oncology but concentrates on clinical studies, both research orientated and treatment orientated, rather than on laboratory studies. Contributions are also welcomed from the fields of epidemiology, tumor pathology, radiobiology and radiation physics.
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