Caccialanza Riccardo, Cotogni Paolo, Cereda Emanuele, Bossi Paolo, Aprile Giuseppe, Delrio Paolo, Gnagnarella Patrizia, Mascheroni Annalisa, Monge Taira, Corradi Ettore, Grieco Michele, Riso Sergio, De Lorenzo Francesco, Traclò Francesca, Iannelli Elisabetta, Beretta Giordano Domenico, Zanetti Michela, Cinieri Saverio, Zagonel Vittorina, Pedrazzoli Paolo
Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Pain Management and Palliative Care, Department of Anesthesia, Intensive Care and Emergency, Molinette Hospital, University of Turin, Turin, Italy.
J Cancer. 2022 May 21;13(9):2705-2716. doi: 10.7150/jca.73130. eCollection 2022.
Malnutrition is a frequent problem in cancer patients, which leads to prolonged and repeated hospitalizations, increased treatment-related toxicity, reduced response to cancer treatment, impaired quality of life, a worse overall prognosis and the avoidable waste of health care resources. Despite being perceived as a limiting factor in oncologic treatments by both oncologists and patients, there is still a considerable gap between need and actual delivery of nutrition care, and attitudes still vary considerably among health care professionals. In the last 5 years, the Italian Intersociety Working Group for Nutritional Support in Cancer Patients (WG), has repeatedly revisited this issue and has concluded that some improvement in nutritional care in Italy has occurred, at least with regard to awareness and institutional activities. In the same period, new international guidelines for the management of malnutrition and cachexia have been released. Despite these valuable initiatives, effective structural strategies and concrete actions aimed at facing the challenging issues of nutritional care in oncology are still needed, requiring the active participation of scientific societies and health authorities. As a continuation of the WG's work, we have reviewed available data present in the literature from January 2016 to September 2021, together with the most recent guidelines issued by scientific societies and health authorities, thus providing an update of the 2016 WG practical recommendations, with suggestions for new areas/issues for possible improvement and implementation.
营养不良是癌症患者中常见的问题，会导致住院时间延长和反复住院、治疗相关毒性增加、对癌症治疗的反应降低、生活质量受损、总体预后更差以及医疗资源的可避免浪费。尽管肿瘤学家和患者都认为营养不良是肿瘤治疗的一个限制因素，但营养护理的需求与实际提供之间仍存在相当大的差距，而且医护人员的态度也存在很大差异。在过去5年中，意大利癌症患者营养支持跨学会工作组（WG）多次重新审视这个问题，并得出结论认为，意大利在营养护理方面至少在意识和机构活动方面有了一些改善。同期，发布了关于营养不良和恶病质管理的新国际指南。尽管有这些宝贵的举措，但仍需要有效的结构性策略和具体行动来应对肿瘤营养护理中的挑战性问题，这需要科学学会和卫生当局的积极参与。作为WG工作的延续，我们回顾了2016年1月至2021年9月文献中的现有数据，以及科学学会和卫生当局发布的最新指南，从而更新了2016年WG的实用建议，并对可能改进和实施的新领域/问题提出了建议。
