Ottery F D, Walsh D, Strawford A
Ottery & Associates, Oncology Care Consultants, Philadelphia, PA 19106, USA.
Semin Oncol. 1998 Apr;25(2 Suppl 6):35-44.
Anorexia is a symptom seen in the majority of patients with cancer or the acquired immunodeficiency syndrome (AIDS) who experience involuntary weight loss. It is frequently not seen as a symptom requiring management in the same proactive manner as pain, nausea, or constipation. Progressive inanition or wasting is a fundamental component of the complex phenomenon known as the anorexia/cachexia syndrome (ACS) of malignancy or AIDS. Weight loss can be seen in the full spectrum of patient care settings: as a presenting complaint, defining condition, treatment-related toxicity, or as a hallmark of impending death. Primary pharmacologic management of ACS includes use of orexigenic agents (appetite stimulants), anticatabolic agents (antimetabolic and anticytokine), and anabolic agents (primarily hormonal). In addition to these specific categories of pharmacologic intervention, broad aspects of symptom management need to be addressed and are complementary. The available literature evaluating pharmacologic management of ACS in both malignancy and AIDS is reviewed.
厌食是大多数癌症患者或获得性免疫缺陷综合征(艾滋病)患者出现的一种症状,这些患者会出现非自愿体重减轻。它常常不被视为一种需要像疼痛、恶心或便秘那样积极处理的症状。进行性消瘦或恶病质是恶性肿瘤或艾滋病所致的厌食/恶病质综合征(ACS)这一复杂现象的基本组成部分。体重减轻可见于患者护理的各个环节:作为就诊主诉、明确病情、治疗相关毒性反应,或作为濒死的标志。ACS的主要药物治疗包括使用食欲促进剂(食欲兴奋剂)、抗分解代谢剂(抗代谢药和抗细胞因子药)以及合成代谢剂(主要是激素类)。除了这些特定类别的药物干预措施外,还需要关注症状管理的广泛方面,它们是相辅相成的。本文综述了评估恶性肿瘤和艾滋病中ACS药物治疗的现有文献。