Department of Anesthesia, Pain Management and Palliative Care, Intensive Care and Emergency, Molinette Hospital, University of Turin, 10126 Turin, Italy.
Medical Oncology 1, Veneto Institute of Oncology-IRCCS, 35128 Padova, Italy.
Nutrients. 2021 Jan 22;13(2):306. doi: 10.3390/nu13020306.
The role of nutritional support for cancer patients in palliative care is still a controversial topic, in part because there is no consensus on the definition of a palliative care patient because of ambiguity in the common medical use of the adjective palliative. Nonetheless, guidelines recommend assessing nutritional deficiencies in all such patients because, regardless of whether they are still on anticancer treatments or not, malnutrition leads to low performance status, impaired quality of life (QoL), unplanned hospitalizations, and reduced survival. Because nutritional interventions tailored to individual needs may be beneficial, guidelines recommend that if oral food intake remains inadequate despite counseling and oral nutritional supplements, home enteral nutrition or, if this is not sufficient or feasible, home parenteral nutrition (supplemental or total) should be considered in suitable patients. The purpose of this narrative review is to identify in these cancer patients the area of overlapping between the two therapeutic approaches consisting of nutritional support and palliative care in light of the variables that determine its identification (guidelines, evidence, ethics, and law). However, nutritional support for cancer patients in palliative care may be more likely to contribute to improving their QoL when part of a comprehensive early palliative care approach.
癌症患者姑息治疗中的营养支持作用仍然是一个有争议的话题，部分原因是由于形容词姑息在医学上的常用定义不明确，姑息治疗患者的定义没有达成共识。尽管如此，指南还是建议对所有此类患者评估营养缺乏情况，因为无论他们是否仍在接受抗癌治疗，营养不良都会导致体能状态下降、生活质量受损、非计划性住院和生存时间缩短。由于针对个体需求的营养干预可能有益，因此，如果尽管进行了咨询和口服营养补充，但口服食物摄入仍然不足，指南建议在合适的患者中考虑家庭肠内营养，如果这不够或不可行，则考虑家庭肠外营养（补充或完全）。本叙述性综述的目的是根据确定其身份的变量（指南、证据、伦理和法律），确定姑息治疗中营养支持和姑息治疗这两种治疗方法之间的重叠领域。然而，当姑息治疗中的营养支持成为综合早期姑息治疗方法的一部分时，更有可能有助于提高癌症患者的生活质量。
