Cotogni Paolo, Bozzetti Federico, Goldwasser François, Jimenez-Fonseca Paula, Roelsgaard Obling Sine, Valle Juan W
Pain Management and Palliative Care, Department of Anesthesia, Intensive Care and Emergency, Molinette Hospital, University of Turin, Corso Bramante 88-90, Turin 10126, Italy.
Faculty of Medicine, University of Milan, Milan, Italy.
Ther Adv Med Oncol. 2022 Sep 26;14:17588359221113691. doi: 10.1177/17588359221113691. eCollection 2022.
Malnutrition is an often-overlooked challenge for patients with cancer. It is associated with muscle mass reduction, poor compliance and response to cancer treatments, decreased quality of life, and reduced survival time. The nutritional assessment and intervention should be a vital part of any comprehensive cancer treatment plan. However, data on artificial nutrition supplied based on caloric needs during cancer care are scarce. In this review, we discuss the recommendations of the European and American societies for clinical nutrition on the use of nutritional interventions in malnourished patients with cancer in the context of current clinical practice. In particular, when enteral nutrition (oral or tube feeding) is not feasible or fails to meet the complete nutritional needs, supplemental parenteral nutrition (SPN) can bridge the gap. We report the available evidence on SPN in cancer patients and identify the perceived barriers to the wider application of this intervention. Finally, we suggest a 'permissive' role of SPN in cancer care but highlight the need for rigorous clinical studies to further evaluate the use of SPN in different populations of cancer patients.
营养不良是癌症患者一个常常被忽视的挑战。它与肌肉量减少、对癌症治疗的依从性和反应不佳、生活质量下降以及生存时间缩短有关。营养评估和干预应是任何综合癌症治疗计划的重要组成部分。然而，关于癌症治疗期间根据热量需求提供人工营养的数据却很匮乏。在本综述中，我们结合当前临床实践，讨论欧美临床营养学会对营养不良癌症患者使用营养干预措施的建议。特别是，当肠内营养（口服或管饲）不可行或无法满足全部营养需求时，补充性肠外营养（SPN）可以弥补这一缺口。我们报告了关于癌症患者SPN的现有证据，并确定了这种干预措施广泛应用所面临的明显障碍。最后，我们建议SPN在癌症治疗中发挥“许可性”作用，但强调需要进行严格的临床研究，以进一步评估SPN在不同癌症患者群体中的应用。
