Unit of Medical Oncology and Biomolecular Therapy, Department of Medical and Surgical Sciences - Policlinico Riuniti, University of Foggia, Foggia, Italy.
University Service of Diet Therapy and Metabolic Diseases, Department of Clinical and Exprerimental Medicine - Policlinico Riuniti, University of Foggia, 71122 Foggia, Italy.
Oncologist. 2023 Sep 7;28(9):e793-e800. doi: 10.1093/oncolo/oyad101.
At diagnosis, more than 80% of patients with pancreatic cancer (PC) suffer from significant weight loss due to malnutrition which is a major concern for patient management, and this may negatively impact treatment outcomes and patient prognosis.
We performed an observational, retrospective study on patients with metastatic PC (mPC) undergoing first-line chemotherapy with nab-Paclitaxel containing schedules and receiving or not receiving nutritional support (NS) and pancreatic enzyme replacement therapy (PERT) to investigate their relevance in this setting.
We observed that PERT and ancillary dietary interventions are related to longer overall survival (OS; median: 16.5 vs. 7.5 months, P < .001) and have a significant, independent, prognostic impact for better outcomes (P = .013), independently from the therapeutic regimen. Furthermore, PERT and NS prevented weight loss during chemotherapy and obtained an improvement of nutritional parameters such as phase angle and free-fat mass index, after 3 months of anticancer treatment. Consistently, the positive impact on OS correlated also with the prevention of Karnofsky performance status deterioration and a lower incidence of maldigestion-related symptoms.
Our data suggest that an early and well-conducted NS in patients with mPC may impact on survival and preserve performance status, thus improving quality of life.
在诊断时，超过 80%的胰腺癌 (PC) 患者由于营养不良而遭受严重的体重减轻，这是患者管理的主要关注点，并且这可能对治疗结果和患者预后产生负面影响。
我们对接受含 nab-紫杉醇一线化疗且接受或未接受营养支持 (NS) 和胰酶替代治疗 (PERT) 的转移性 PC (mPC) 患者进行了一项观察性、回顾性研究，以研究其在这种情况下的相关性。
我们观察到 PERT 和辅助饮食干预与更长的总生存期 (OS; 中位数：16.5 与 7.5 个月，P <.001) 相关，并且具有独立的预后影响，可带来更好的结局 (P =.013)，独立于治疗方案。此外，PERT 和 NS 可防止化疗期间体重减轻，并在接受抗癌治疗 3 个月后改善营养参数，如相位角和游离脂肪质量指数。一致地，对 OS 的积极影响还与预防卡氏功能状态恶化和降低与消化不良相关的症状发生率相关。
我们的数据表明，mPC 患者早期和良好的 NS 可能会影响生存并保持身体状况，从而提高生活质量。
