Karlberg H I, Fischer J E
West J Med. 1982 May;136(5):390-7.
A growing body of work has been addressed to the hypothesis that because patients with cancer who have poor nutritional status have a worse prognosis, increased nutritional support in these patients will result in better tolerance of surgical interventions, chemotherapy and radiation therapy, and a better outcome from the cancer. Although the hypothesis is an attractive one, there is only a single well-conducted, randomized, prospective trial to date that shows that active nutritional support is of benefit in the therapy of patients with cancer. Based on this review of the literature, it is felt that though cachexia is clearly of negative import in patients with cancer, there is little evidence to support the hypotheses that any nutritional support changes the outcome or the course of therapy of patients with cancer. It seems reasonable to continue the nutritional support to cachectic patients with cancer concomitant with specific anticancer therapy, but supportive nutritional therapy alone with postponement of specific anticancer treatment, as in awaiting weight gain or anabolism, cannot be justified with the current state of the art.
由于营养状况差的癌症患者预后较差,因此增加这些患者的营养支持将使其对手术干预、化疗和放疗具有更好的耐受性,并使癌症治疗获得更好的结果。尽管这一假设很有吸引力,但迄今为止只有一项精心设计的随机前瞻性试验表明,积极的营养支持对癌症患者的治疗有益。基于对文献的综述,人们认为,虽然恶病质在癌症患者中显然具有负面意义,但几乎没有证据支持任何营养支持会改变癌症患者的治疗结果或治疗过程这一假设。在进行特定抗癌治疗的同时,继续对患有癌症的恶病质患者进行营养支持似乎是合理的,但就目前的技术水平而言,仅采用支持性营养疗法而推迟特定抗癌治疗(如等待体重增加或合成代谢)是不合理的。