Kidd Andrew C, Skrzypski Marcin, Jamal-Hanjani Mariam, Blyth Kevin G
Institute of Immunity, Infection and Inflammation, University of Glasgow.
Queen Elizabeth University Hospital, Glasgow.
Curr Opin Support Palliat Care. 2019 Dec;13(4):316-322. doi: 10.1097/SPC.0000000000000465.
Thoracic malignancies are amongst the most lethal of all cancers. Cancer cachexia lacks unanimously accepted diagnostic criteria, and therefore is referenced to as a conceptual framework whereby cancer cachexia is 'an ongoing loss of skeletal muscle mass (termed sarcopenia), with or without loss of fat mass that cannot be reversed by conventional nutritional support and leads to progressive functional impairment'. This review summarises the current evidence base in this field, including imaging techniques currently used to define sarcopenia, inflammatory and metabolic changes associated with the syndrome and ongoing research into potential treatment strategies.
Sarcopenia is a key component of the cancer cachexia syndrome. It is common in patients with both early-stage and advanced NSCLC. Patients with sarcopenia have more treatment-related side effects and poorer overall survival compared with nonsarcopenic patients.
Early identification of cancer cachexia may facilitate stratification of patients most-at-risk and initiation of emerging anticachexia treatments. If these are proven to be effective, this strategy has the potential to improve tolerance to anti-cancer therapies, improving the quality of life, and perhaps the survival, of patients with thoracic malignancies.
胸部恶性肿瘤是所有癌症中致死率最高的疾病之一。癌症恶病质缺乏一致公认的诊断标准，因此被视为一个概念框架，即癌症恶病质是“骨骼肌质量持续减少（称为肌肉减少症），伴有或不伴有脂肪量减少，且无法通过传统营养支持逆转，并导致进行性功能障碍”。本综述总结了该领域的当前证据基础，包括目前用于定义肌肉减少症的成像技术、与该综合征相关的炎症和代谢变化以及对潜在治疗策略的正在进行的研究。
肌肉减少症是癌症恶病质综合征的关键组成部分。在早期和晚期非小细胞肺癌患者中都很常见。与非肌肉减少症患者相比，肌肉减少症患者有更多与治疗相关的副作用，总体生存率更低。
早期识别癌症恶病质可能有助于对高危患者进行分层，并启动新出现的抗恶病质治疗。如果这些治疗被证明有效，该策略有可能提高对抗癌治疗的耐受性，改善胸部恶性肿瘤患者的生活质量，甚至可能提高生存率。
