Planas M, Puiggrós C, Redecillas S
Unidad de Soporte Nutricional, Hospital Universitario Vall d'Hebron, Barcelona.
Nutr Hosp. 2006 May;21 Suppl 3:27-36.
To increase dietary intake and to fight anorexia several measures to treat symptoms and administer the most adequate diet according to composition, texture and flavour are proposed. However, in the anorexia-caquexia present in cancer patients not always these measures are effective. Now a day it seems more reasonable to approach this problem with different strategies directed to modulate the pathologic alterations associated. The analysis of specific nutritional support as part as the treatment of these patients from a systematic review conclude that no high methodological quality studies to analyze the impact of oral supplementation on a specific group of patients, neither the study of functional effects are done. However, an increase in the total energy intake, not maintained over the time, was observed. The effects on weight and corporal composition are variable, with small differences between groups with o without supplementation and confuse due to, mainly, the heterogeneity of the patients included in the different studies analyzed. The analysis of the effects of nutritional supplements administered by enteral feeding shown an increase in the energy intake with an increase in body weight or a lack of decrease it, and with some functional and clinical beneficial effects. Despite the results and conclusions obtained, a strong recommendation to conduct clinical trials in specific group of cancer patients with different antineoplasic treatment seems necessary. N-3 fatty acids, especially eicosapentaenoic acid may have anticachectic properties. Although further trials are necessary the limited results available suggests that nutritional supplements enriched with EPA may reverse cachexia in cancer patients.
为了增加饮食摄入量并对抗厌食症，人们提出了几种措施来治疗症状，并根据成分、质地和口味提供最适宜的饮食。然而，对于癌症患者出现的恶病质厌食症，这些措施并非总能奏效。如今，采用不同策略来调节相关病理改变似乎更为合理。一项系统评价对这些患者治疗中特定营养支持的分析得出结论，尚无高质量的方法学研究来分析口服补充剂对特定患者群体的影响，也未进行功能效应研究。然而，观察到总能量摄入量有所增加，但未持续很长时间。对体重和身体成分的影响各不相同，补充剂组和未补充剂组之间差异不大，主要是由于不同研究所纳入患者的异质性而导致结果混淆。对肠内喂养营养补充剂效果的分析表明，能量摄入量增加，体重增加或未减轻，并且有一些功能和临床益处。尽管得出了这些结果和结论，但似乎有必要强烈建议针对接受不同抗肿瘤治疗的特定癌症患者群体开展临床试验。n-3脂肪酸，尤其是二十碳五烯酸可能具有抗恶病质特性。尽管还需要进一步试验，但现有有限的结果表明，富含二十碳五烯酸的营养补充剂可能会逆转癌症患者的恶病质。
