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头颈部鳞状细胞癌的营养问题:这是肿瘤学家的职责所在吗?多学科团队的作用——一篇叙述性文献综述

Nutrition in HNSCC: is it a matter for oncologists? The role of multidisciplinary team-a narrative literature review.

作者信息

Denaro Nerina, Bareggi Claudia, Galassi Barbara, Beltramini Giada, Wekking Demi, Proh Michele, Ibba Tullio, Solinas Cinzia, Garrone Ornella

机构信息

Oncologia Medica Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda, Ospedale Maggiore Policlinico Milano, Milan, Italy.

Chirurgia Maxillofacciale Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico Milano, Milan, Italy.

出版信息

Front Oncol. 2024 Jul 3;14:1430845. doi: 10.3389/fonc.2024.1430845. eCollection 2024.

Abstract

BACKGROUND

Malnutrition, defined as weight loss and unsatisfactory nutrient intake, is very common in patients with head and neck squamous cell carcinoma (HNSCC) in either the early or palliative setting. Despite increased awareness, nutritional programs are not yet adequately implemented in these patients. There are several reasons for this delay: differences in composition, the expertise of the multidisciplinary teams involved in HNSCC patients' treatment, and economic and network resources conditioning faster or slower nutritional supply delivery. This situation affects the outcomes and the quality of life of HNSCC patients.

MATERIALS AND METHODS

We investigated available literature about nutritional support in HNSCC patients and its impact on outcomes, prognosis, and quality of life, and we focused on the role of the multidisciplinary team. We considered 8,491 articles, and after excluding duplicates and manuscripts not written in English, 1,055 were analyzed and 73 were deemed eligible for the present work.

RESULTS

After the literature review, we can state that malnutrition, sarcopenia, and cachexia are associated with systemic inflammation and closely correlated with poor outcomes. An evaluation of the nutritional status of the multidisciplinary team before, during, and after therapy could improve patient outcomes, as the goal of the therapeutic approach is widely designed.

CONCLUSIONS

We suggest that the treatment workflow definition is fundamental and propose a tailored nutritional approach that could benefit HNSCC patients' outcomes and quality of life. These results could be achieved by a multidisciplinary team.

摘要

背景

营养不良定义为体重减轻和营养摄入不足,在早期或姑息治疗阶段的头颈部鳞状细胞癌(HNSCC)患者中非常常见。尽管人们的认识有所提高,但这些患者的营养计划仍未得到充分实施。造成这种延迟的原因有几个:组成差异、参与HNSCC患者治疗的多学科团队的专业知识,以及影响营养供应交付速度快慢的经济和网络资源。这种情况影响了HNSCC患者的治疗结果和生活质量。

材料与方法

我们调查了有关HNSCC患者营养支持及其对治疗结果、预后和生活质量影响的现有文献,并重点关注了多学科团队的作用。我们考虑了8491篇文章,在排除重复文章和非英文撰写的手稿后,对1055篇进行了分析,其中73篇被认为符合本研究的要求。

结果

经过文献综述,我们可以指出,营养不良、肌肉减少症和恶病质与全身炎症相关,并且与不良治疗结果密切相关。由于治疗方法的目标已广泛确定,因此在治疗前、治疗期间和治疗后对多学科团队的营养状况进行评估可以改善患者的治疗结果。

结论

我们认为治疗工作流程的定义至关重要,并提出一种量身定制的营养方法,这可能有益于HNSCC患者的治疗结果和生活质量。这些结果可以通过多学科团队实现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6633/11251948/c6686a3b3031/fonc-14-1430845-g001.jpg

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