Couch Marion E, Dittus Kim, Toth Michael J, Willis Monte S, Guttridge Denis C, George Jonathan R, Chang Eric Y, Gourin Christine G, Der-Torossian Hirak
Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Vermont Cancer Center, University of Vermont, College of Medicine, Burlington, Vermont.
Division of Hematology-Oncology, Department of Medicine, Vermont Cancer Center, University of Vermont, College of Medicine, Burlington, Vermont.
Head Neck. 2015 Jul;37(7):1057-72. doi: 10.1002/hed.23696. Epub 2015 Apr 7.
The pathophysiology of cancer cachexia remains complex. A comprehensive literature search was performed up to April 2013 using PubMed, the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, and the Google search engine. In this review, we focus on the different mediators of impaired anabolism and upregulated catabolism that alter the skeletal muscle homeostasis resulting in the wasting of cancer cachexia. We present recent evidence of targeted treatment modalities from clinical trials along with their potential mechanisms of action. We also report on the most current evidence from randomized clinical trials using multimodal treatments in patients with cancer cachexia, but also the evidence from head and neck cancer-specific trials. A more complete understanding of the pathophysiology of the syndrome may lead to more effective targeted therapies and improved outcomes for patients.
癌症恶病质的病理生理学仍然很复杂。截至2013年4月，使用PubMed、Cochrane图书馆、护理及相关健康文献累积索引以及谷歌搜索引擎进行了全面的文献检索。在本综述中，我们重点关注合成代谢受损和分解代谢上调的不同介质，这些介质会改变骨骼肌的内环境稳态，导致癌症恶病质的消瘦。我们展示了来自临床试验的靶向治疗方式的最新证据及其潜在作用机制。我们还报告了使用多模式治疗癌症恶病质患者的随机临床试验的最新证据，以及头颈癌特异性试验的证据。对该综合征病理生理学的更全面理解可能会带来更有效的靶向治疗，并改善患者的预后。
