Heber D, Byerley L O, Chi J, Grosvenor M, Bergman R N, Coleman M, Chlebowski R T
Cancer. 1986 Oct 15;58(8 Suppl):1867-73. doi: 10.1002/1097-0142(19861015)58:8+<1867::aid-cncr2820581413>3.0.co;2-a.
A number of common metastatic cancers are associated with marked weight loss at the time of diagnosis. Cancer patients with weight loss at the time of diagnosis have decreased mean survival compared to similar cancer patients without weight loss. Provision of excess calories alone does not appear to change median survival in patients with advanced cancer and many patients either maintain body weight or lose weight while receiving calories which would be predicted to result in weight gain. The authors recently have extended their studies to head and neck cancer patients without detectable metastatic disease in order to detect systemic metabolic effects of a localized tumor. These patients failed to gain weight despite the administration of apparently adequate calories by continuous enteral alimentation. Abnormalities of carbohydrate metabolism with secondary effects on fat and protein metabolism have been identified in several populations of patients with common cancers. These abnormalities offer potential points of intervention which may enhance nutritional therapy as rehabilitation and as a potential biological modifier of the response of specific cancers to chemotherapy, radiation therapy, or surgery.
许多常见的转移性癌症在诊断时都伴有明显的体重减轻。与体重未减轻的类似癌症患者相比，诊断时体重减轻的癌症患者平均生存期缩短。仅提供额外的热量似乎并不能改变晚期癌症患者的中位生存期，而且许多患者在摄入预计会导致体重增加的热量时，体重要么维持不变，要么继续减轻。作者最近将研究扩展到无可检测转移性疾病的头颈癌患者，以检测局部肿瘤的全身代谢效应。尽管通过持续肠内营养给予了明显充足的热量，但这些患者仍未能增重。在几类常见癌症患者中已发现碳水化合物代谢异常，并继发影响脂肪和蛋白质代谢。这些异常提供了潜在的干预点，可能会加强营养治疗，作为康复手段以及作为特定癌症对化疗、放疗或手术反应的潜在生物调节剂。
