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非小细胞肺癌中的肌肉紊乱和营养机制改变。

Muscle derangement and alteration of the nutritional machinery in NSCLC.

机构信息

Medical Oncology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.

Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona, Italy.

出版信息

Crit Rev Oncol Hematol. 2019 Sep;141:43-53. doi: 10.1016/j.critrevonc.2019.06.007. Epub 2019 Jun 15.

Abstract

Weight loss and depletion of nutritional status are frequent presentation hallmarks in non-small cell lung cancer (NSCLC). Decline in muscle mass is a major component in weight loss and may have both a prognostic and predictive value for survival and treatment-related toxicities. Recent findings suggest that weight and skeletal muscle mass gain during treatment may represent surrogate markers for outcome in advanced NSCLC patients. Herein we present an in-depth view of the impact of nutritional status derangements on NSCLC patients' outcome, focusing on lean body mass variations during disease course. We explored the impact of malnutrition with a major attention on novel treatment options. We reviewed molecular, metabolic and immunological mechanisms underlying muscle-wasting condition, which may exhibit a meaningful targeting potential. Incorporating a specialized and accurate body composition assessment into a comprehensive, patient-centered and tailored intervention will facilitate the achievement of nutritional goals and optimal care for lung cancer patients.

摘要

体重下降和营养状态消耗是非小细胞肺癌(NSCLC)的常见表现特征。肌肉质量下降是体重下降的主要组成部分,对生存和与治疗相关的毒性具有预后和预测价值。最近的研究结果表明,治疗期间的体重和骨骼肌质量增加可能是晚期 NSCLC 患者治疗结果的替代标志物。本文深入探讨了营养状况失调对 NSCLC 患者预后的影响,重点关注疾病过程中瘦体重的变化。我们探讨了营养不良的影响,特别关注新的治疗选择。我们回顾了肌肉减少症的分子、代谢和免疫学机制,这些机制可能具有有意义的靶向潜力。将专门而准确的身体成分评估纳入全面、以患者为中心和量身定制的干预措施中,将有助于实现营养目标并为肺癌患者提供最佳护理。

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