Tchekmedyian N S, Zahyna D, Halpert C, Heber D
Pacific Coast Hematology/Oncology Medical Group, St. Mary Medical Center, Long Beach, CA.
Oncology (Williston Park). 1992 Feb;6(2 Suppl):105-11.
Variables that the clinician can assess to determine the nutritional status of cancer patients include percent and rate of weight loss from usual body weight, current weight compared to calculated ideal body weight, and levels of appetite and food intake. Our studies show that two-thirds of patients with advanced cancer over the age of 65 have had some degree of weight loss, and that more than half are underweight, have loss of appetite, or complain of a decrease in food intake. Ongoing support and education, food supplementation, and attention to activity level may all contribute to preserve the patient's nutritional status and quality of life. Severe, persistent anorexia that does not respond to dietary counseling can be reversed with megestrol acetate. Enteral and parenteral nutrition have specific indications but should not be routinely used in anorectic patients.
临床医生可用于评估癌症患者营养状况的变量包括自通常体重的体重减轻百分比和速率、当前体重与计算出的理想体重的比较，以及食欲和食物摄入量水平。我们的研究表明，三分之二年龄超过65岁的晚期癌症患者有一定程度的体重减轻，并且超过一半的患者体重过轻、食欲不振或主诉食物摄入量减少。持续的支持与教育、食物补充以及对活动水平的关注均可能有助于维持患者的营养状况和生活质量。对饮食咨询无反应的严重、持续性厌食可通过醋酸甲地孕酮逆转。肠内和肠外营养有特定指征，但不应常规用于厌食患者。
