Molfino Alessio, Amabile Maria Ida, Muscaritoli Maurizio
Department of Clinical Medicine, Sapienza University of Rome, Italy.
Curr Opin Support Palliat Care. 2018 Dec;12(4):434-438. doi: 10.1097/SPC.0000000000000383.
Patients with cancer present high risk for involuntary body weight loss and reduced food intake, which, contributing to progressive tissue wasting and affecting the nutritional status, are often under-estimated in the clinical practice. In this article, we aimed at focusing on cancer-associated weight loss and investigating recent evidences on the indications of nutritional interventions to treat this condition.
During the last few years, increased emphasis has been addressed on the mechanisms underlying body weight loss in cancer that can be induced by either cancer metabolism and inflammation, either several side-effects of the anticancer treatments. This led to consider clinical parameters, such as BMI, body weight change and food intake, and their modification overtime, in predicting patient's overall survival. In this light, nutritional support has to be considered to maintain or restore nutritional status, improve tolerance to oncological therapies, and ameliorate physical performance and quality of life.
Increased awareness on weight loss in cancer patients and on cancer cachexia is needed to carry out a nutritional assessment at an early stage of cancer journey and to establish its management and nutritional support to obtain advantages in terms of treatment tolerance and clinical outcomes.
癌症患者存在非自愿体重减轻和食物摄入量减少的高风险，这会导致进行性组织消耗并影响营养状况，在临床实践中常常被低估。在本文中，我们旨在聚焦癌症相关体重减轻，并研究关于治疗这种情况的营养干预指征的最新证据。
在过去几年中，人们越来越重视癌症患者体重减轻的潜在机制，这可能是由癌症代谢和炎症，或抗癌治疗的几种副作用引起的。这使得人们在预测患者的总生存期时，会考虑临床参数，如体重指数（BMI）、体重变化和食物摄入量，以及它们随时间的变化。有鉴于此，必须考虑给予营养支持，以维持或恢复营养状况，提高对肿瘤治疗的耐受性，并改善身体机能和生活质量。
需要提高对癌症患者体重减轻和癌症恶病质的认识，以便在癌症病程的早期阶段进行营养评估，并建立其管理和营养支持措施，从而在治疗耐受性和临床结果方面获得优势。
