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癌症恶病质中的肌肉减少症:临床意义、诊断和新兴治疗策略。

Muscle wasting in cancer cachexia: clinical implications, diagnosis, and emerging treatment strategies.

机构信息

GTx, Inc., Memphis, Tennessee 38103-2802, USA.

出版信息

Annu Rev Med. 2011;62:265-79. doi: 10.1146/annurev-med-061509-131248.

Abstract

Cancer cachexia is a complex metabolic condition characterized by loss of skeletal muscle. Common clinical manifestations include muscle wasting, anemia, reduced caloric intake, and altered immune function, which contribute to increased disability, fatigue, diminished quality of life, and reduced survival. The prevalence of cachexia and the impact of this disorder on the patient and family underscore the need for effective management strategies. Dietary supplementation and appetite stimulation alone are inadequate to reverse the underlying metabolic abnormalities of cancer cachexia and have limited long-term impact on patient quality of life and survival. Therapies that can increase muscle mass and physical performance may be a promising option; however, there are currently no drugs approved for the prevention or treatment of cancer cachexia. Several agents are in clinical development, including anabolic agents, such as selective androgen receptor modulators and drugs targeting inflammatory cytokines that promote skeletal muscle catabolism.

摘要

癌症恶病质是一种以骨骼肌丧失为特征的复杂代谢状况。常见的临床症状包括肌肉减少、贫血、热量摄入减少以及免疫功能改变,这些症状导致残疾、疲劳、生活质量下降和存活率降低的风险增加。恶病质的流行程度以及这种疾病对患者和家庭的影响突显了制定有效管理策略的必要性。单独的饮食补充和食欲刺激不足以逆转癌症恶病质的潜在代谢异常,对患者的生活质量和生存的长期影响有限。能够增加肌肉质量和身体表现的治疗方法可能是一个有前途的选择;然而,目前尚无预防或治疗癌症恶病质的药物获得批准。目前有几种药物正在临床开发中,包括合成代谢剂,如选择性雄激素受体调节剂和靶向促进骨骼肌分解的炎性细胞因子的药物。

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