Lövey József
Sugárterápiás Központ, Országos Onkológiai Intézet, Budapest, Hungary.
Magy Onkol. 2017 Sep 20;61(3):229-237. Epub 2017 Jul 28.
The majority of cancer patients becomes malnourished during the course of their disease. Malnutrition deteriorates the efficiency of all kinds of oncologic interventions. As a consequence of it, treatment-related toxicity increases, hospital stay is lengthened, chances of cure and survival as well as the quality of life of the patients worsen. Nutritional status therefore influences all aspects of outcome of oncology care. In spite of this the use of nutritional therapy varies across health care providers but its application is far from being sufficient during active oncology interventions as well as rehabilitation and supportive care. It threatens not only the outcome and quality of life of cancer patients but also the success of oncologic treatments which often demand high input of human and financial resources. Meanwhile application of nutritional therapy is legally regulated in Hungary and a very recent update of the European guideline on cancer patient nutrition published in 2017 is available. Moreover, cost effectiveness of nutritional therapy has been proven in a number of studies. In this review we present the basics of nutritional therapy including nutritional screening and evaluation, nutritional plan, the role of nutrition support teams, oral, enteral and parenteral nutrition, the use of different drugs and special nutrients and the follow-up of the patients.
大多数癌症患者在患病过程中会出现营养不良。营养不良会降低各种肿瘤治疗手段的效果。因此，与治疗相关的毒性增加，住院时间延长，治愈和生存的机会以及患者的生活质量都会恶化。营养状况因此影响肿瘤护理结果的各个方面。尽管如此，营养治疗的使用在不同的医疗服务提供者之间存在差异，但其在积极的肿瘤治疗干预以及康复和支持性护理期间的应用远远不够。这不仅威胁到癌症患者的治疗结果和生活质量，也威胁到通常需要大量人力和财力投入的肿瘤治疗的成功。与此同时，匈牙利对营养治疗的应用有法律规定，并且可以获取2017年发布的欧洲癌症患者营养指南的最新更新。此外，营养治疗的成本效益在多项研究中得到了证实。在本综述中，我们介绍了营养治疗的基础知识，包括营养筛查和评估、营养计划、营养支持团队的作用、口服、肠内和肠外营养、不同药物和特殊营养素的使用以及患者的随访。
