Couch Marion, Lai Victor, Cannon Trinitia, Guttridge Denis, Zanation Adam, George Jonathan, Hayes D Neil, Zeisel Steven, Shores Carol
Department of Otolaryngology/Head and Neck Surgery, University of North Carolina School of Medicine, G0412 Neurosciences Hospital, Chapel Hill, NC 27599-7070, USA.
Head Neck. 2007 Apr;29(4):401-11. doi: 10.1002/hed.20447.
Cancer cachexia is a debilitating, wasting condition that affects many cancer patients, including those with head and neck cancer. The overall incidence of cancer cachexia is quite high for some types of cancer, and cachexia will be the main cause of death for more than 20% of all cancer patients. This syndrome uniquely challenges patients with head and neck cancer. This article outlines the diagnosis of cancer cachexia, reviews its impact on patient quality of life (QOL) and survival, and updates the reader on potential therapies that may suppress it.
A comprehensive literature search was performed using PubMed of the National Library of Medicine, which includes more than 15 million citations back to the 1950s. The Cochrane Library and Google search engine were used as well.
This syndrome differs significantly from starvation, and thus accurate and timely diagnosis is essential. Nutritional therapy alone is insufficient. Current management strategies include corticosteroids and megesterol acetate, in conjunction with nutritional therapy. Future strategies may include nutraceuticals, omega-3 fatty acids, inflammatory antagonists, and other targeted treatments.
Because cancer cachexia differs significantly from starvation, nutritional supplementation must be used in conjunction with other anti-cachexia agents to reverse the chronic systemic inflammatory state and the effects of circulating tumor-derived factors seen in cachexia. Careful identification of patients at risk and those suffering from this syndrome will lead to better outcomes and treatments. Ultimately, more research is needed to better treat this devastating condition.
癌症恶病质是一种使人衰弱的消耗性病症，影响许多癌症患者，包括头颈癌患者。某些类型癌症的癌症恶病质总体发病率相当高，恶病质将成为超过20%的所有癌症患者的主要死因。这种综合征给头颈癌患者带来了独特的挑战。本文概述了癌症恶病质的诊断，回顾了其对患者生活质量（QOL）和生存的影响，并向读者介绍了可能抑制它的潜在治疗方法。
使用美国国立医学图书馆的PubMed进行了全面的文献检索，该数据库包含可追溯到20世纪50年代的超过1500万条引文。还使用了考克兰图书馆和谷歌搜索引擎。
这种综合征与饥饿有显著差异，因此准确及时的诊断至关重要。仅营养治疗是不够的。目前的管理策略包括皮质类固醇和醋酸甲地孕酮，结合营养治疗。未来的策略可能包括营养保健品、ω-3脂肪酸、炎症拮抗剂和其他靶向治疗。
由于癌症恶病质与饥饿有显著差异，营养补充必须与其他抗恶病质药物联合使用，以逆转慢性全身炎症状态以及恶病质中所见的循环肿瘤衍生因子的影响。仔细识别有风险的患者和患有这种综合征的患者将带来更好的结果和治疗。最终，需要更多的研究来更好地治疗这种毁灭性疾病。
