Division of Medical Oncology, Department of Oncology, Mayo Clinic, Rochester, Minnesota, USA.
Nutr Cancer. 2011 Nov;63(8):1251-5. doi: 10.1080/01635581.2011.607543. Epub 2011 Oct 14.
Loss of appetite and weight predict poor outcomes in patients with advanced cancer. Effective and affordable palliative strategies are lacking; but because an emerging non-cancer literature suggests that alcohol can increase appetite and weight, this study explored associations between alcohol and clinical outcomes in lung cancer patients. Among 404 consecutive lung cancer patients enrolled in the Mayo Clinic Lung Cancer Cohort between 2004 and 2008, alcohol consumption (within 6 mo of diagnosis) was as follows: 199 (49%) used none, 158 (14%) were moderate users (7 drinks per wk or less), and 47 (12%) were heavier consumers (more than 7 drinks per wk). Only heavier consumers had a lower likelihood of anorexia (odds ratio: 0.49; 95% CI: 0.25, 0.94; P = 0.03) and weight loss (odds ratio: 0.43; 95% CI: 0.20, 0.91; P = 0.03) compared to those who consumed no alcohol. These conclusions were sustained in multivariate analyses. Neither moderate nor heavier consumption was associated with better or worse survival, although, in univariate analyses, a drop in alcohol consumption was associated with worse survival. This report suggests a need for further study of alcohol as a palliative agent for cancer-associated loss of appetite and weight.
食欲不振和体重下降预示着晚期癌症患者预后不良。目前缺乏有效且负担得起的姑息治疗策略;但由于新出现的非癌症文献表明,酒精可以增加食欲和体重,因此本研究探讨了肺癌患者的酒精摄入量与临床结局之间的关联。在 2004 年至 2008 年间纳入梅奥诊所肺癌队列的 404 例连续肺癌患者中,酒精摄入量(在诊断后 6 个月内)如下:199 例(49%)未饮酒,158 例(14%)为中度饮酒者(每周 7 杯或更少),47 例(12%)为重度饮酒者(每周超过 7 杯)。只有重度饮酒者发生厌食症的可能性较低(比值比:0.49;95%置信区间:0.25,0.94;P = 0.03),体重减轻的可能性也较低(比值比:0.43;95%置信区间:0.20,0.91;P = 0.03)与不饮酒者相比。这些结论在多变量分析中得到了维持。中度和重度饮酒均与更好或更差的生存无关,尽管在单变量分析中,酒精摄入量下降与生存恶化相关。本报告表明,需要进一步研究酒精作为癌症相关食欲和体重下降的姑息治疗剂。