Ockenga J, Pirlich M, Gastell S, Lochs H
Medizinische Klinik mit Schwerpunkt Gastroenterologie, Hepatologie und Endokrinologie, Humboldt Universität, Charité, Berlin, Germany.
Z Gastroenterol. 2002 Nov;40(11):929-36. doi: 10.1055/s-2002-35411.
The development of progressive malnutrition or cachexia is frequent in patients with gastrointestinal cancer - especially in patients with a carcinoma of the pancreas. The cachexia syndrome which is characterised by loss of body weight, negative nitrogen balance and fatigue significantly affects patients' quality of life, morbidity and survival. Because the currently established therapeutical strategies are often disappointing many physicians tended to develop a therapeutical nihilism. Cancer anorexia and cachexia are two distinct syndromes which may have synergistic effects in a patient. This review highlights the growing understanding of the multidimensional pathophysiological background. An algorithm of the current treatment strategies is given. In addition, we discuss new anabolic and anticatabolic agents (e.g. eicosapentanoic acid) and the results from first clinical trials.
进行性营养不良或恶病质在胃肠道癌患者中很常见，尤其是胰腺癌患者。以体重减轻、负氮平衡和疲劳为特征的恶病质综合征会显著影响患者的生活质量、发病率和生存率。由于目前既定的治疗策略往往令人失望，许多医生倾向于产生治疗虚无主义。癌症厌食症和恶病质是两种不同的综合征，在患者身上可能具有协同作用。本综述强调了对多维病理生理背景的日益深入的理解。给出了当前治疗策略的算法。此外，我们还讨论了新的合成代谢和抗分解代谢药物（如二十碳五烯酸）以及首批临床试验的结果。
