Buzby G P, Mullen J L, Stein T P, Miller E E, Hobbs C L, Rosato E F
Cancer. 1980 Jun 15;45(12):2940-8. doi: 10.1002/1097-0142(19800615)45:12<2940::aid-cncr2820451208>3.0.co;2-p.
Adequate parenteral nutritional support improves nutritional status in cancer patients, but its effect on tumor growth remains controversial. Using a transplantable mammary adenocarcinoma in a rat-TPN model, the relative effect of different exogenous intravenous nutrients on tumor growth and host maintenance was studied. Relative to chow controls, starvation increased host depletion without reducing tumor growth. Adequate carbohydrate calories alone neither improved host maintenance nor stimulated tumor growth, yet adequate amino acids alone did improve host maintenance but also stimulated tumor growth. Adequate amino acids and carbohydrates given simultaneously maximized both host maintenance and tumor growth. In contrast, an isocaloric, isonitrogenous, intravenous diet providing non-nitrogenous calories as fat promoted host maintenance equivalent to carbohydrate-based TPN with no tumor stimulation. This apparent differential utilization of fat calories by normal and malignant cells may permit manipulation of the relative benefit of parenteral nutrition to host or to tumor, permitting host repletion without tumor stimulation or alternatively tumor stimulation at appropriate times to increase sensitivity to phase-specific antineoplastic therapy.
充足的肠外营养支持可改善癌症患者的营养状况，但其对肿瘤生长的影响仍存在争议。在大鼠全胃肠外营养（TPN）模型中，使用可移植的乳腺腺癌，研究了不同外源性静脉营养对肿瘤生长和宿主维持的相对影响。相对于正常饮食对照组，饥饿增加了宿主的消耗，却未降低肿瘤生长。仅提供充足的碳水化合物热量既未改善宿主维持状况，也未刺激肿瘤生长，然而仅提供充足的氨基酸确实改善了宿主维持状况，但也刺激了肿瘤生长。同时给予充足的氨基酸和碳水化合物可使宿主维持和肿瘤生长均达到最大化。相比之下，一种以脂肪提供非氮热量的等热量、等氮静脉饮食促进宿主维持的效果与基于碳水化合物的TPN相当，且不会刺激肿瘤生长。正常细胞和恶性细胞对脂肪热量的这种明显不同利用方式，可能有助于操控肠外营养对宿主或肿瘤的相对益处，从而在不刺激肿瘤的情况下实现宿主营养补充，或者在适当的时候刺激肿瘤生长，以增加对特定阶段抗肿瘤治疗的敏感性。
