Vigano A, Watanabe S, Bruera E
Palliative Care Program, Edmonton General Hospital, Canada.
Cancer Surv. 1994;21:99-115.
Cachexia is a frequent and devastating complication of advanced cancer. Current understanding of the pathophysiology of this syndrome implicates tumour induced metabolic changes and immune responses. Clinical manifestation include anorexia, chronic nausea, asthenia and change in body image. Aggressive nutritional intervention has not been shown to be of benefit. Patients and families should be counselled about the goals of nutritional intake. In selected cases, enteral nutrition may be appropriate. Pharmacological management should first be directed at correcting nausea. Agents of potential usefulness in the treatment of anorexia include corticosteroids, megestrol acetate, cyproheptadine, hydrazine sulphate and dronabinol. Future research should further address pathophysiology, symptomatic and metabolic effects of interventions and interactions with other syndromes of terminal cancer.
恶病质是晚期癌症常见且严重的并发症。目前对该综合征病理生理学的理解涉及肿瘤诱导的代谢变化和免疫反应。临床表现包括厌食、慢性恶心、乏力和身体形象改变。积极的营养干预尚未显示出益处。应向患者及其家属提供有关营养摄入目标的咨询。在某些情况下，肠内营养可能是合适的。药物治疗应首先针对纠正恶心。在治疗厌食方面可能有用的药物包括皮质类固醇、醋酸甲地孕酮、赛庚啶、硫酸肼和屈大麻酚。未来的研究应进一步探讨病理生理学、干预措施的症状和代谢效应以及与晚期癌症其他综合征的相互作用。
