Rickard K A, Coates T D, Grosfeld J L, Weetman R M, Baehner R L
Cancer. 1986 Oct 15;58(8 Suppl):1904-10. doi: 10.1002/1097-0142(19861015)58:8+<1904::aid-cncr2820581419>3.0.co;2-4.
A positive stance towards nutrition support of the child with cancer assures potential for normal growth, development, and quality of life during extended oncologic treatment. Data from recent studies of children with cancer (advanced neuroblastoma, Wilms' tumor) demonstrate the importance of integrating nutrition staging, assessment, and support into treatment protocols. Patients with solid tumors and lymphomas who are malnourished at diagnosis have a poor outcome when compared to nourished counterparts. Enteral nutrition (intensive nutrition counseling and favorite, nutritious foods) is effective in low nutritional risk groups but ineffective in preventing or reversing protein-energy malnutrition in high nutritional risk groups. For high-risk groups, central parenteral nutrition is a relatively short-term, but important, support measure which allows children to grow despite extended periods of intense oncologic treatment. The patient's nutritional course may affect bone marrow suppression and the ability to tolerate aggressive chemotherapeutic treatment. Although treatment tolerance may be improved with nutrition support, adequacy of primary oncologic treatment outweighs other supportive factors as a determinant of ultimate survival.
对癌症患儿的营养支持采取积极态度，可确保其在长期肿瘤治疗期间实现正常生长、发育并享有良好生活质量。近期针对癌症患儿（晚期神经母细胞瘤、肾母细胞瘤）的研究数据表明，将营养分期、评估和支持纳入治疗方案具有重要意义。与营养状况良好的实体瘤和淋巴瘤患者相比，诊断时营养不良的患者预后较差。肠内营养（强化营养咨询及提供患儿喜爱的营养丰富的食物）对低营养风险组有效，但对高营养风险组预防或逆转蛋白质 - 能量营养不良无效。对于高风险组，中心静脉肠外营养是一种相对短期但重要的支持措施，可使患儿在长时间的强化肿瘤治疗期间仍能生长。患者的营养状况可能会影响骨髓抑制以及耐受积极化疗的能力。尽管营养支持可能会改善治疗耐受性，但作为最终生存的决定因素，原发性肿瘤治疗的充分性比其他支持因素更为重要。
