WVU Charleston Division, West Virginia, USA.
Oncologist. 2011;16(5):704-7. doi: 10.1634/theoncologist.2011-0001. Epub 2011 Apr 6.
There really should not be a debate about the use of neutropenic diet for cancer patients. Its usefulness has never been scientifically proven. However, neutropenic diets remain in place in many institutions even though their usefulness is controversial. Neutropenic diets were once thought to be important in protecting patients from having to succumb to infection from neutropenia while undergoing chemotherapy. Although food may contain harmful organisms and research has shown that bacterial translocation is possible, recent studies have been unable to obtain significant differences between placebo and intervention groups. The dietetic challenges neutropenic patients struggle with include decreased quality of life, malnutrition, gastrointestinal side effects, food aversion, and impaired cell-mediated immunity from vitamin deficiency. Unanswered questions in regard to the neutropenic diet include the following: (a) which food should be included; (b) which food preparation techniques improve patient compliance; (c) which patient populations benefit most; and (d) when should such a diet be initiated. Without scientific evidence, the best advice for neutropenic patients is to follow food safety guidelines as indicated by government entities.
对于癌症患者使用降低中性粒细胞饮食,其实不应该存在争议。它的有效性从未在科学上得到证实。然而,尽管其有效性存在争议,许多机构仍然在使用降低中性粒细胞饮食。降低中性粒细胞饮食曾经被认为对于保护接受化疗的患者免受中性粒细胞减少引起的感染非常重要。尽管食物可能含有有害的生物体,并且研究表明细菌易位是可能的,但最近的研究未能在安慰剂和干预组之间获得显著差异。中性粒细胞减少症患者面临的饮食挑战包括生活质量下降、营养不良、胃肠道副作用、食物厌恶以及维生素缺乏导致的细胞介导免疫受损。关于降低中性粒细胞饮食的未解决问题包括:(a) 应包括哪些食物;(b) 哪种食物准备技术可提高患者的依从性;(c) 哪些患者群体受益最大;以及(d) 何时应开始这种饮食。由于缺乏科学证据,对于中性粒细胞减少症患者的最佳建议是按照政府机构的指示遵循食品安全指南。