Phillips Iain, Hug Adele, Allan Lindsey, Ezhil Veni
Edinburgh Cancer Centre, Western General Hospital, Edinburgh.
St Lukes Cancer Centre, Royal Surrey County Hospital, Guildford, UK.
Curr Opin Support Palliat Care. 2019 Dec;13(4):311-315. doi: 10.1097/SPC.0000000000000453.
Systemic therapy for lung cancer is increasing in intensity and duration. European nutrition guidelines suggest screening for weight loss and malnutrition, however acknowledges there is a lack of evidence. We discuss current data round this issue and identify opportunities for further research.
International guidelines now exist to aid the definition of weight loss in cancer, including cachexia, sarcopenia and malnutrition. These allow consistent definition of overlapping, but distinct clinical syndromes. Nutritional status can be assessed in a range of ways including questionnaires, functional assessments, blood markers, physical activity, weight and BMI. Weight loss is commonly associated with a proinflammatory state. Future treatment is likely to be a combination of dietetic support and pharmacological treatment of cachexia.
There is a paucity of data on dietetic intervention. It is potentially quick, inexpensive and patient specific, using a holistic approach to aid patients who are malnourished or at risk of malnutrition. Lung cancer-related weight loss is common, further strategies are needed to effectively assess and intervene. Dietetic intervention has the potential to improve patients' quality of life and outcomes.
肺癌的全身治疗在强度和持续时间上都在增加。欧洲营养指南建议筛查体重减轻和营养不良，但也承认缺乏相关证据。我们讨论了围绕这个问题的当前数据，并确定了进一步研究的机会。
现在有国际指南来帮助定义癌症中的体重减轻，包括恶病质、肌肉减少症和营养不良。这些指南允许对重叠但不同的临床综合征进行一致的定义。营养状况可以通过多种方式进行评估，包括问卷调查、功能评估、血液标志物、身体活动、体重和体重指数。体重减轻通常与促炎状态有关。未来的治疗可能是营养支持和恶病质药物治疗的结合。
关于营养干预的数据很少。营养干预可能快速、廉价且针对患者个体，采用整体方法来帮助营养不良或有营养不良风险的患者。肺癌相关的体重减轻很常见，需要进一步的策略来有效评估和干预。营养干预有可能改善患者的生活质量和治疗结果。
