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癌症恶病质:一种多因素疾病,需要多模式治疗方法。

Cancer cachexia: a multifactoral disease that needs a multimodal approach.

机构信息

Houston Methodist Hospital Cancer Center.

Lynda K and David M Underwood Center for Digestive Disorders, Houston Methodist Hospital, Houston, Texas, USA.

出版信息

Curr Opin Gastroenterol. 2020 Mar;36(2):141-146. doi: 10.1097/MOG.0000000000000603.

Abstract

PURPOSE OF REVIEW

Cancer cachexia is a complex condition that occurs in approximately 50% of cancer patients and in 80% of those with advanced cancer. It is characterized by lean body mass loss, adipose tissue loss, altered metabolism, increased inflammation, and a decrease in quality of life. Cancer cachexia is a frustrating condition to manage and treatment requires an innovative approach. The purpose of this article is to review the current treatments for cancer cachexia and how they could be used in a multimodal approach.

RECENT FINDINGS

Cancer cachexia has many causes, but is primarily a result of reduced energy-protein intake and altered metabolism augmented by a proinflammatory state. There is not a formal consensus on diagnosing cancer cachexia, but proactive screening and assessments for malnutrition are an effective first step toward identifying high-risk patients. Treatment of cancer cachexia includes optimizing nutrition care, using appropriate pharmacological agents, preserving lean body mass, and the cooperation of the healthcare team.

SUMMARY

Cancer cachexia is a complex multifactorial condition that can only be successfully managed and treated with a multimodal approach that involves a multidisciplinary team that includes an oncology registered dietitian nutritionist and exercise physiologist that target early detection and management of cancer cachexia.

摘要

目的综述

癌症恶病质发生于约 50%的癌症患者,80%的晚期癌症患者中,是一种复杂的病症。其特征为去脂体重降低、体脂丢失、代谢改变、炎症增加和生活质量下降。癌症恶病质的管理极具挑战性,需要创新的治疗方法。本文的目的是综述癌症恶病质的现有治疗方法,以及如何将这些方法用于多模式治疗。

最新发现

癌症恶病质有多种病因,但主要是由于能量-蛋白质摄入减少和代谢改变,以及促炎状态所致。癌症恶病质的诊断尚无正式共识,但主动筛查和营养不良评估是识别高危患者的有效第一步。癌症恶病质的治疗包括优化营养护理、使用适当的药物治疗、保留瘦体重以及医疗团队的合作。

总结

癌症恶病质是一种复杂的多因素疾病,只能通过多模式方法成功管理和治疗,该方法涉及包括肿瘤学注册营养师和运动生理学家在内的多学科团队,其目标是早期发现和管理癌症恶病质。

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