Second Department of Internal Medicine, "Victor Babeș" University of Medicine and Pharmacy, 300041 Timisoara, Romania.
Department of Oncology, "Victor Babeș" University of Medicine and Pharmacy, 300041 Timisoara, Romania.
Medicina (Kaunas). 2022 Jul 21;58(7):966. doi: 10.3390/medicina58070966.
: The prevalence of cachexia has increased across all of the cancer types and accounts for up to 20% of cancer-related deaths. This paper is a systematic review of nutritional interventions aiming to improve cachexia outcomes in cancer, focusing on weight gain. : A search in Medline and Elsevier databases for articles up until the 23 January 2022, was conducted. : Out of 5732 screened records, 26 publications were included in the final analysis. Four randomized clinical trials showed a significant body weight (BW) increase in patients treated with eicosapentaenoic acid (EPA), β-hydroxy-beta-methyl butyrate (β-HMB), arginine, and glutamine or marine phospholipids (MPL). An upward BW trend was observed in patients treated with L-carnitine, an Ethanwell/Ethanzyme (EE) regimen enriched with ω-3 fatty acids, micronutrients, probiotics, fish oil, a leucine-rich supplement, or total parental nutrition (TPN) with a high dose of a branched-chain amino acid (BCAA). : Although clinical trials relating to large numbers of nutritional supplements present promising data, many trials provided negative results. Further studies investigating the underlying mechanisms of action of these nutritional supplements in cancer cachexia are needed. Early screening for cancer cachexia risk and nutritional intervention in cancer patients before aggravating weight loss may stabilize their weight, preventing cachexia syndrome. According to the GRADE methodology, no positive recommendation for these nutritional supplements may be expressed.
恶病质在所有癌症类型中的发病率都有所增加,约占癌症相关死亡的 20%。本文是对旨在改善癌症恶病质结局的营养干预措施的系统评价,重点关注体重增加。
对 Medline 和 Elsevier 数据库中的文章进行了截至 2022 年 1 月 23 日的检索。
在筛选出的 5732 份记录中,有 26 篇出版物被纳入最终分析。四项随机临床试验显示,接受二十碳五烯酸 (EPA)、β-羟基-β-甲基丁酸 (β-HMB)、精氨酸和谷氨酰胺或海洋磷脂 (MPL)治疗的患者体重明显增加。接受左旋肉碱、富含 ω-3 脂肪酸、微量营养素、益生菌、鱼油、富含亮氨酸的补充剂或高剂量支链氨基酸 (BCAA) 的总胃肠外营养 (TPN) 的患者体重呈上升趋势。
虽然涉及大量营养补充剂的临床试验提供了有希望的数据,但许多试验结果为阴性。需要进一步研究这些营养补充剂在癌症恶病质中的作用机制。早期筛查癌症恶病质风险,并在体重下降加重前对癌症患者进行营养干预,可能有助于稳定体重,预防恶病质综合征。根据 GRADE 方法,不能对这些营养补充剂做出积极推荐。