Oncological Palliative Medicine, Division of Oncology/Hematology, Department of Internal Medicine and Palliative Care Center, Cantonal Hospital, Switzerland.
Support Care Cancer. 2010 Mar;18(3):273-9. doi: 10.1007/s00520-009-0800-6.
Involuntary weight loss, the defining factor of cachexia, is a common consequence of advanced cancer.
This review summarizes the actual cachexia definitions and classification systems (NCCTG-studies, Loprinzi et al.; PG-SGA, Ottery et al.; Cachexia Consensus Conference, Evans et al; Cancer Cachexia Study Group, Fearon et al.; and SCRINIO Working group, Bozzetti et al.).We describe the ongoing development of a new classification system for cancer cachexia, which is based on literature reviews and Delphi processes within the European Palliative Care Research Collaborative. The review describes the evolving understanding of the pathophysiological mechanisms of cachexia and outlines an overview on treatment options.
In this review an outlook on the requirements of a new decision guiding instrument is given and the challenges in clinical decision making in palliative are discussed.
消瘦是恶病质的决定性因素,是晚期癌症的常见后果。
本文综述了恶病质的实际定义和分类系统(NCCTG 研究、Loprinzi 等人;PG-SGA、Ottery 等人;恶病质共识会议、Evans 等人;癌症恶病质研究小组、Fearon 等人;和 SCRINIO 工作组、 Bozzetti 等人)。我们描述了一种新的癌症恶病质分类系统的正在开发,该系统基于文献回顾和欧洲姑息治疗研究协作组内的 Delphi 过程。该综述描述了对恶病质病理生理机制的不断发展的理解,并概述了治疗选择。
本文展望了一种新的决策指导工具的要求,并讨论了姑息治疗中临床决策的挑战。