Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, P.O. Box 263, 00029 HUS, Helsinki, Finland.
Faculty of Medicine, Research Program in Systems Oncology, University of Helsinki, Helsinki, Finland.
Adv Ther. 2022 Apr;39(4):1502-1523. doi: 10.1007/s12325-022-02074-9. Epub 2022 Feb 27.
Patients with head and neck cancer (HNC) are usually confronted with functional changes due to the malignancy itself or its treatment. These factors typically affect important structures involved in speech, breathing, chewing, swallowing, and saliva production. Consequently, the intake of food will be limited, which further contributes to loss of body weight and muscle mass, anorexia, malnutrition, fatigue, and anemia. This multifactorial condition can ultimately lead to cancer cachexia syndrome. This study aims to examine the treatment of cachexia in HNC patients.
We systematically searched OvidMedline, PubMed, Scopus, and Web of Science for articles examining the treatment of cachexia in HNC.
A total of nine studies were found, and these suggested interventions including nutritional, pharmacologic, therapeutic exercise, and multimodal approaches. The nutritional intervention includes essential components such as dietary counseling, oral nutritional supplements, and medical nutritional support. Individualized nutritional interventions include oral, enteral (feeding tubes i.e., percutaneous endoscopic gastrostomy [PEG], nasogastric tube [NGT]) and parenteral nutrition. The pharmacologic interventions aim at increasing the appetite and weight of cachectic patients. Therapeutic exercise and increased physical activity can help to enhance the synthesis of muscle protein, reducing inflammation and the catabolic effects of cachexia syndrome.
Owing to the multifactorial nature of this syndrome, it is expected that the management approach should be multi-interventional. Early implementation of these interventions may help to improve survival and quality of health and life of cachectic HNC patients.
头颈部癌症（HNC）患者通常会因恶性肿瘤本身或其治疗而导致功能改变。这些因素通常会影响到与言语、呼吸、咀嚼、吞咽和唾液分泌有关的重要结构。因此，食物的摄入量会受到限制，这进一步导致体重和肌肉量的减少、厌食、营养不良、疲劳和贫血。这种多因素的情况最终可能导致癌症恶病质综合征。本研究旨在探讨头颈部癌症患者恶病质的治疗方法。
我们系统地在 OvidMedline、PubMed、Scopus 和 Web of Science 中搜索了关于头颈部癌症恶病质治疗的文章。
共发现 9 项研究，这些研究提出了包括营养、药物、治疗性运动和多模式方法等干预措施。营养干预包括饮食咨询、口服营养补充剂和医学营养支持等基本组成部分。个体化营养干预包括口服、肠内（即经皮内镜胃造口术[PEG]、鼻胃管[NGT]）和肠外营养。药物干预旨在增加恶病质患者的食欲和体重。治疗性运动和增加身体活动有助于增强肌肉蛋白的合成，减轻炎症和恶病质综合征的分解代谢作用。
由于这种综合征的多因素性质，预计管理方法应该是多干预性的。早期实施这些干预措施可能有助于改善恶病质头颈部癌症患者的生存和健康及生活质量。
