Department of Nutrition, Food and Exercise Sciences, The Florida State University, 120 Convocation Way, PO Box 3061493, Tallahassee, FL 32306-1493, USA.
Anticancer Agents Med Chem. 2013 Oct;13(8):1197-203. doi: 10.2174/18715206113139990322.
Several nutritional assessment tools have been used in oncology settings to monitor nutritional status and its associated prognostic significance. Body composition is fundamental for the assessment of nutritional status. Recently, the use of accurate and precise body composition tools has significantly added to the value of nutritional assessment in this clinical setting. Computerized tomography (CT) is an example of a technique which provides state-of-the-art assessment of body composition. With use of CT images, a great variability in body composition of cancer patients has been identified even in people with identical body weight or body mass index. Severe muscle depletion (sarcopenia) has emerged as a prevalent body composition phenotype which is predictive of poor functional status, shorter time to tumor progression, shorter survival, and higher incidence of dose-limiting toxicity. Variability in body composition of cancer patients may be a source of disparities in the metabolism of cytotoxic agents. Future clinical trials investigating dose reductions in patients with sarcopenia and dose-escalating studies based on pre-treatment body composition assessment have the potential to alter cancer treatment paradigms.
多种营养评估工具已在肿瘤学领域用于监测营养状况及其相关的预后意义。身体成分是评估营养状况的基础。最近，准确和精确的身体成分工具的使用显著提高了营养评估在这一临床环境中的价值。计算机断层扫描（CT）是一种提供身体成分最新评估的技术。利用 CT 图像，即使在体重或身体质量指数相同的人群中，也发现了癌症患者身体成分的巨大差异。严重的肌肉耗竭（肌少症）已成为一种普遍的身体成分表型，可预测功能状态不佳、肿瘤进展时间更短、生存时间更短以及更高的剂量限制毒性发生率。癌症患者身体成分的差异可能是细胞毒性药物代谢差异的一个来源。未来的临床试验可以研究在肌少症患者中减少剂量，以及基于治疗前身体成分评估的剂量递增研究，有可能改变癌症治疗模式。
