Hopkinson Jane B, Okamoto Ikumi, Addington-Hall Julia M
School of Health Sciences, University of Southampton, Southampton, UK,
Support Care Cancer. 2011 Jan;19(1):1-17. doi: 10.1007/s00520-010-0964-0. Epub 2010 Aug 6.
The aim of this study was to report a systematic search and narrative review of the evidence base that can inform dietary advice for patients off treatment living with cancer cachexia syndrome (CCS).
Searches were conducted in MEDLINE, EMBASE, PsycINFO and CINAHL databases for publications about diet and cancer patients off treatment with symptoms of CCS. The following limits were applied: English language, from September 1998 to September 2008 and adults. In addition, a hand search included the reference lists of papers identified. Seven hundred and eighteen abstracts were assessed against inclusion/exclusion criteria and 88 were selected for full text independent examination by two researchers. Information from 48 papers was extracted, quality assessed, thematically analyzed and presented as a narrative synthesis.
Two dominant perspectives emerged on what should be eaten by weight-losing cancer patients. The majority of authors advocated a nutrient-dense diet, facilitated by nutritional counselling. The alternative approach was to advise the patient to 'eat what they want'. There is little robust evidence to justify either approach as able to deliver on the range of physical and psychosocial objectives that they aim to achieve.
A new model for the delivery of nutritional care may benefit cancer patients (off treatment) living with weight loss. The proposed model integrates the two identified perspectives to facilitate optimal food intake taking into account the patient's (1) disease symptoms and treatment side effects (2) emotional adaptation to illness and (3) social circumstances. Research is needed to establish which of these obstacles to eating can be changed for which patient groups to improve patient outcomes.
本研究旨在报告一项系统性检索及叙述性综述，以获取可为癌症恶病质综合征（CCS）缓解期患者提供饮食建议的证据基础。
在MEDLINE、EMBASE、PsycINFO和CINAHL数据库中进行检索，查找有关处于缓解期且有CCS症状的癌症患者饮食的出版物。应用以下限制条件：英文文献、1998年9月至2008年9月发表以及针对成年人。此外，手工检索包括已识别论文的参考文献列表。根据纳入/排除标准对718篇摘要进行评估，88篇被选中由两名研究人员进行全文独立审查。从48篇论文中提取信息、进行质量评估、主题分析并以叙述性综述形式呈现。
对于体重减轻的癌症患者应吃什么出现了两种主要观点。大多数作者主张通过营养咨询来实现营养密集型饮食。另一种方法是建议患者“想吃什么就吃什么”。几乎没有有力证据证明这两种方法中的任何一种能够实现它们旨在达成的一系列身体和心理社会目标。
一种新的营养护理提供模式可能使体重减轻的癌症（缓解期）患者受益。所提出的模式整合了已识别的两种观点，以促进最佳食物摄入，同时考虑患者的（1）疾病症状和治疗副作用（（2）对疾病的情绪适应以及（3）社会环境。需要开展研究以确定针对哪些患者群体可以改变哪些饮食障碍，从而改善患者预后。
