Endocrinology Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, 56124 Pisa, Italy.
Dietary Service, University Hospital of Pisa, 56124 Pisa, Italy.
Nutrients. 2022 Mar 18;14(6):1298. doi: 10.3390/nu14061298.
In the last decade, multikinase inhibitors (MKIs) have changed the paradigm of treatment of advanced and progressive thyroid cancer. Compared with the traditional treatment with chemotherapy and radiotherapy, these new drugs have shown a good efficacy in controlling the neoplastic disease, and also a different toxicity profile compared to traditional chemotherapy, milder but still present and involving mainly the nutritional profile. Weight loss, nausea, anorexia, stomatitis, diarrhea may be associated with malnutrition and cancer-related cachexia. The latter is characteristic of the advanced cancer stage and may be present before starting MKIs, or may develop afterwards. Adverse events with nutritional impact may cause a significant impairment of quality of life, often requiring dose reduction and sometimes drug discontinuation, but with a lower efficacy on the neoplastic disease. The aim of this paper was to discuss the role of nutritional therapy in advanced thyroid cancer and the importance of prevention, early recognition and careful management of malnutrition and cachexia during systemic therapy with MKIs.
在过去的十年中，多激酶抑制剂（MKIs）改变了晚期和进展性甲状腺癌的治疗模式。与传统的化疗和放疗相比，这些新药在控制肿瘤疾病方面显示出了良好的疗效，与传统化疗相比也具有不同的毒性谱，其毒性更轻微，但仍然存在，主要涉及营养状况。体重减轻、恶心、厌食、口腔炎、腹泻可能与营养不良和癌症相关的恶病质有关。后者是晚期癌症的特征，可能在开始使用 MKIs 之前存在，也可能在之后发生。具有营养影响的不良事件可能导致生活质量显著下降，通常需要减少剂量，有时甚至需要停止用药，但对肿瘤疾病的疗效降低。本文旨在讨论营养治疗在晚期甲状腺癌中的作用，以及在使用 MKIs 进行全身治疗期间预防、早期识别和精心管理营养不良和恶病质的重要性。
