Department of Women's Cancer, EGA Institute for Women's Health, University College London, London, United Kingdom.
Int J Gynecol Cancer. 2012 Jul;22(6):1089-95. doi: 10.1097/IGC.0b013e318256e4d3.
Malnutrition, suffered by more than 50% of patients with ovarian cancer during the course of their disease, significantly compromises the effectiveness of treatment, causes distress, and increases morbidity and mortality. This review outlines the nutritional challenges faced by women with ovarian cancer and evaluates the evidence base for current practice and possible opportunities for intervention in clinical settings.
PubMed and MetaLib databases were searched for literature on nutrition and cancer/ovarian cancer using terms and truncations covering cancer, cachexia, mouse models, malnutrition, and nutrition intervention. MEDLINE and Cochrane databases were separately searched for interventional studies and clinical and randomized controlled trials published in English (UK/United States) that involved oral nutrition and/or supplementation/intervention in ovarian cancer patients.
Malnutrition continues to be a significant challenge in ovarian cancer management despite significant improvement in treatment pathways and understanding of metabolic pathways and the role of inflammation. There is little evidence of studies designed to evaluate the impact of additional oral nutrients in this population. Seven studies found compared "early" versus "traditional" postoperative oral feeding after major gynecological/oncological surgery, and 1 study evaluated the impact of nutritional status on survival. The 7 studies found evidence of safety, tolerability, reduction in length of hospitalization, and rapid recovery after early feeding. There is no evidence of benefit of additional oral nutrients in this population.
Current guidelines and protocols of nutritional management of ovarian cancer seem to be based on expert opinion. There is need for extensive collaborative evidence for nutritional management decisions made in the treatment of patients. Prospective cohort studies could help evaluate the impact of changes in nutritional status on health/nutritional outcomes, disease recurrence, quality of life, and survival. These would form a basis for well-designed, targeted, randomized controlled trials with specific and controlled nutrients/counseling aimed at preventing rather than treating nutritional complications.
在卵巢癌患者的病程中，超过 50%的患者患有营养不良，这显著降低了治疗效果，导致患者痛苦，并增加发病率和死亡率。本综述概述了卵巢癌患者面临的营养挑战，并评估了当前实践的证据基础和临床环境中干预的可能机会。
使用涵盖癌症、恶病质、小鼠模型、营养不良和营养干预的术语和截断符，在 PubMed 和 MetaLib 数据库中搜索关于癌症/卵巢癌营养的文献。分别在 MEDLINE 和 Cochrane 数据库中搜索发表在英国/美国的英文期刊上的关于卵巢癌患者的口服营养和/或补充/干预的干预研究和临床随机对照试验。
尽管治疗途径和代谢途径以及炎症作用的理解都有了显著的改善，但在卵巢癌管理中，营养不良仍然是一个重大挑战。几乎没有证据表明有研究旨在评估在该人群中额外口服营养素的影响。有 7 项研究比较了妇科/肿瘤手术后“早期”与“传统”的口服喂养，1 项研究评估了营养状况对生存的影响。这 7 项研究证明了早期喂养的安全性、耐受性、住院时间缩短和快速恢复。在该人群中没有证据表明额外口服营养素有益。
目前卵巢癌营养管理的指南和方案似乎基于专家意见。需要广泛的协作证据来支持治疗患者时做出的营养管理决策。前瞻性队列研究可以帮助评估营养状况变化对健康/营养结果、疾病复发、生活质量和生存的影响。这些将为有针对性、有针对性、随机对照试验提供基础，这些试验具有特定和受控的营养素/咨询，旨在预防而不是治疗营养并发症。
