医学研究与教育 ›› 2021, Vol. 38 ›› Issue (5): 36-44.DOI: 10.3969/j.issn.1674-490X.2021.05.006
张晓凤1,张一曼2,张红杰1
收稿日期:
2021-09-22
出版日期:
2021-10-25
发布日期:
2021-10-25
通讯作者:
张红杰(1966—),女,河北保定人,教授,硕士,硕士生导师,主要从事社区健康教育、传染病和慢性病预防和控制工作。E-mail: 1003759461@qq.com
作者简介:
张晓凤(1995—),女,河北石家庄人,在读硕士,主要从事流行病与卫生统计。 E-mail: 1578310404@qq.com
Received:
2021-09-22
Online:
2021-10-25
Published:
2021-10-25
摘要: 癌症患者营养不良发生率高,与患者的治疗效果差及不良预后关系密切,营养补充意义重大。口服营养补充剂是胃肠道功能基本正常的癌症患者进行营养补充的首选途径。对于治疗期间的癌症患者来说,口服营养补充剂能够帮助其维持体质量、改善营养状况、降低术后感染风险、提高治疗耐受性、降低短期再入院率及提高短期生存率。且营养干预时间越早,越有利于患者的治疗及预后。但营养补充在缩短住院时间、提高生活质量及降低病死率方面的效果存在争议,仍需进一步的深入研究。主要对癌症患者口服营养补充剂的效果进行综述,以提高医院、患者及家属对口服营养补充剂的重视。
中图分类号:
张晓凤,张一曼,张红杰. 癌症患者服用口服营养补充剂的效果[J]. 医学研究与教育, 2021, 38(5): 36-44.
[1] WU C C, LI M N, MENG H B, et al.Analysis of status and countermeasures of cancer incidence and mortality in China[J].Sci China Life Sci, 2019, 62(5): 640-647.DOI: 10.1007/s11427-018-9461-5. [2] VAN CUTSEM E, ARENDS J.The causes and consequences of cancer-associated malnutrition[J].Eur J Oncol Nurs, 2005, 9(Suppl 2): S51-S63.DOI: 10.1016/j.ejon.2005.09.007. [3] TOBERT C M, HAMILTON-REEVES J M, NORIAN L A, et al.Emerging impact of malnutrition on surgical patients: literature review and potential implications for cystectomy in bladder cancer[J].J Urol, 2017, 198(3): 511-519. DOI: 10.1016/j.juro.2017.01.087. [4] 马月, 吴蓓雯.癌症患者营养管理指南解读[J].上海护理, 2017, 17(2): 10-15.DOI: 10.3969/j.issn.1009-8399.2017.02.002. [5] 王水莲, 杨芳.预后营养指数对癌症患者预后的临床意义[J].现代肿瘤医学, 2019, 27(6): 1083-1086.DOI: 10.3969/j.issn.1672-4992.2019.06.044. [6] ARENDS J, BACHMANN P, BARACOS V, et al.ESPEN guidelines on nutrition in cancer patients[J].Clin Nutr, 2017, 36(1): 11-48.DOI: 10.1016/j.clnu.2016.07.015. [7] 中国抗癌协会, 中国抗癌协会肿瘤营养与支持治疗专业委员会, 中国抗癌协会癌症康复与姑息治疗专业委员会, 等.口服营养补充指南[J].肿瘤代谢与营养电子杂志, 2015, 2(4): 33-34.DOI: 10.16689/j.cnki.cn11-9349/r.2015.04.019. [8] 中华医学会肠外肠内营养学分会.成人口服营养补充专家共识[J].中华胃肠外科杂志, 2017, 20(4): 361-365.DOI: 10.3760/cma.j.issn.1671-0274.2017.04.001. [9] 吕家华, 李涛, 朱广迎, 等.肠内营养对食管癌同步放化疗患者营养状况、不良反应和近期疗效影响: 前瞻性、多中心、随机对照临床研究(NCT02399306)[J].中华放射肿瘤学杂志, 2018, 27(1): 44-48.DOI: 10.3760/cma.j.issn.1004-4221.2018.01.009. [10] RINNINELLA E, FAGOTTI A, CINTONI M, et al.Nutritional interventions to improve clinical outcomes in ovarian cancer: a systematic review of randomized controlled trials[J].Nutrients, 2019, 11(6): 1404.DOI: 10.3390/nu11061404. [11] CEDERHOLM T, BOSAEUS I, BARAZZONI R, et al.Diagnostic criteria for malnutrition—an ESPEN Consensus Statement[J].Clin Nutr, 2015, 34(3): 335-340.DOI: 10.1016/j.clnu.2015.03.001. [12] FEARON K, STRASSER F, ANKER S D, et al.Definition and classification of cancer cachexia: an international consensus[J].Lancet Oncol, 2011, 12(5): 489-495.DOI: 10.1016/S1470-2045(10)70218-7. [13] BLAUWHOFF-BUSKERMOLEN S, VERSTEEG K S, DE VAN DER SCHUEREN M A, et al.Loss of muscle mass during chemotherapy is predictive for poor survival of patients with metastatic colorectal cancer[J].J Clin Oncol, 2016, 34(12): 1339-1344.DOI: 10.1200/JCO.2015.63.6043. [14] DIRKS M L, WALL B T, VAN DE VALK B, et al.One week of bed rest leads to substantial muscle atrophy and induces whole-body insulin resistance in the absence of skeletal muscle lipid accumulation[J].Diabetes, 2016, 65(10): 2862-2875.DOI: 10.2337/db15-1661. [15] SNIJDERS T, RES P T, SMEETS J S, et al.Protein ingestion before sleep increases muscle mass and strength gains during prolonged resistance-type exercise training in healthy young men[J].J Nutr, 2015, 145(6): 1178-1184.DOI: 10.3945/jn.114.208371. [16] PRADO C M.Body composition in chemotherapy: the promising role of CT scans[J].Curr Opin Clin Nutr Metab Care, 2013, 16(5): 525-533.DOI: 10.1097/MCO.0b013e328363bcfb. [17] PRADO C M, LIEFFERS J R, MCCARGAR L J, et al.Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: a population-based study[J].Lancet Oncol, 2008, 9(7): 629-635.DOI: 10.1016/S1470-2045(08)70153-0. [18] PRADO C M, BARACOS V E, MCCARGAR L J, et al.Sarcopenia as a determinant of chemotherapy toxicity and time to tumor progression in metastatic breast cancer patients receiving capecitabine treatment[J].Clin Cancer Res, 2009, 15(8): 2920-2926.DOI: 10.1158/1078-0432.ccr-08-2242. [19] MARTIN L, SENESSE P, GIOULBASANIS I, et al.Diagnostic criteria for the classification of cancer-associated weight loss[J].J Clin Oncol, 2015, 33(1): 90-99.DOI: 10.1200/jco.2014.56.1894. [20] MURPHY R A, WILKE M S, PERRINE M, et al.Loss of adipose tissue and plasma phospholipids: relationship to survival in advanced cancer patients[J].Clin Nutr, 2010, 29(4): 482-487.DOI: 10.1016/j.clnu.2009.11.006. [21] COOPER A B, SLACK R, FOGELMAN D, et al.Characterization of anthropometric changes that occur during neoadjuvant therapy for potentially resectable pancreatic cancer[J].Ann Surg Oncol, 2015, 22(7): 2416-2423.DOI: 10.1245/s10434-014-4285-2. [22] IMAMURA H, NISHIKAWA K, KISHI K, et al.Effects of an oral elemental nutritional supplement on post-gastrectomy body weight loss in gastric cancer patients: a randomized controlled clinical trial[J].Ann Surg Oncol, 2016, 23(9): 2928-2935.DOI: 10.1245/s10434-016-5221-4. [23] KIMURA Y, NISHIKAWA K, KISHI K, et al.Long-term effects of an oral elemental nutritional supplement on post-gastrectomy body weight loss in gastric cancer patients(KSES002)[J].Ann Gastroenterol Surg, 2019, 3(6): 648-656.DOI: 10.1002/ags3.12290. [24] MIYAZAKI Y, OMORI T, FUJITANI K, et al.Oral nutritional supplements versus a regular diet alone for body weight loss after gastrectomy: a phase 3, multicenter, open-label randomized controlled trial[J].Gastric Cancer, 2021, 24(5): 1150-1159.DOI: 10.1007/s10120-021-01188-3. [25] FEIJÓ P M, RODRIGUES V D, VIANA M S, et al.Effects of ω-3 supplementation on the nutritional status, immune, and inflammatory profiles of gastric cancer patients: a randomized controlled trial[J].Nutrition, 2019, 61: 125-131.DOI: 10.1016/j.nut.2018.11.014. [26] TANAKA N, TAKEDA K, KAWASAKI Y, et al.Early intensive nutrition intervention with dietary counseling and oral nutrition supplement prevents weight loss in patients with advanced lung cancer receiving chemotherapy: a clinical prospective study[J].Yonago Acta Med, 2018, 61(4): 204-212.DOI: 10.33160/yam.2018.12.003. [27] SÁNCHEZ-LARA K, TURCOTT J G, JUÁREZ-HERNÁNDEZ E, et al.Effects of an oral nutritional supplement containing eicosapentaenoic acid on nutritional and clinical outcomes in patients with advanced non-small cell lung cancer: randomised trial[J].Clin Nutr, 2014, 33(6): 1017-1023.DOI: 10.1016/j.clnu.2014.03.006. [28] GÜRLEK GÖKÇEBAY D, EMIR S, BAYHAN T, et al.Assessment of nutritional status in children with cancer and effectiveness of oral nutritional supplements[J].Pediatr Hematol Oncol, 2015, 32(6): 423-432.DOI: 10.3109/08880018.2015.1065303. [29] ZHU M W, YANG X, XIU D R, et al.Effect of oral nutritional supplementation on the post-discharge nutritional status and quality of life of gastrointestinal cancer patients after surgery: a multi-center study[J].Asia Pac J Clin Nutr, 2019, 28(3): 450-456.DOI: 10.6133/apjcn.201909_28(3).0004. [30] CHEN Y X, WU X C, WEI X W, et al.The effect of oral nutritional supplement therapy on nutritional status and quality of life in patients with esophageal cancer undergoing radiotherapy and chemotherapy: a protocol for randomized controlled trial[J].Medicine(Baltimore), 2021, 100(16): e25342.DOI: 10.1097/MD.0000000000025342. [31] 王洋郁, 杨眉, 余家密, 等.老年胃癌患者营养状况调查及其与不同临床因素的相关性[J].肿瘤基础与临床, 2017, 30(4): 313-315.DOI: 10.3969/j.issn.1673-5412.2017.04.013. [32] GARTH A K, NEWSOME C M, SIMMANCE N, et al.Nutritional status, nutrition practices and post-operative complications in patients with gastrointestinal cancer[J].J Hum Nutr Diet, 2010, 23(4): 393-401.DOI: 10.1111/j.1365-277X.2010.01058.x. [33] 陈媛媛, 黄爽, 胡巧英, 等.口服营养补充对鼻咽癌放化疗患者近期营养状况及治疗耐受性影响[J].中华放射肿瘤学杂志, 2019, 28(8): 575-579.DOI: 10.3760/cma.j.issn.1004-4221.2019.08.004. [34] 陈江岩, 柏和, 孙丽华, 等.辽宁省37所医院癌症住院患者首次治疗方式的调查分析[J].中国肿瘤, 2011, 20(10): 719-722. [35] 董兵, 朱毅敏.癌症分子靶向治疗的研究现状[J].癌症, 2010, 29(3): 370-375. [36] WANG J J, LEI K F, HAN F.Tumor microenvironment: recent advances in various cancer treatments[J].Eur Rev Med Pharmacol Sci, 2018, 22(12): 3855-3864.DOI: 10.26355/eurrev_201806_15270. [37] MUN E J, BABIKER H M, WEINBERG U, et al.Tumor-treating fields: a fourth modality in cancer treatment[J].Clin Cancer Res, 2018, 24(2): 266-275.DOI: 10.1158/1078-0432.CCR-17-1117. [38] MORIAS S, MARCU L G, SHORT M, et al.Treatment-related adverse effects in lung cancer patients after stereotactic ablative radiation therapy[J].J Oncol, 2018, 2018: 6483626.DOI: 10.1155/2018/6483626. [39] THOMAS R, HOWARD S A, LAFERRIERE S L, et al.A review of the mechanisms and clinical implications of precision cancer therapy-related toxicity: a primer for the radiologist[J].AJR Am J Roentgenol, 2020, 215(3): 770-780.DOI: 10.2214/AJR.20.22837. [40] BURDEN S T, GIBSON D J, LAL S, et al.Pre-operative oral nutritional supplementation with dietary advice versus dietary advice alone in weight-losing patients with colorectal cancer: single-blind randomized controlled trial[J].J Cachexia Sarcopenia Muscle, 2017, 8(3): 437-446.DOI: 10.1002/jcsm.12170. [41] CEREDA E, CAPPELLO S, COLOMBO S, et al.Nutritional counseling with or without systematic use of oral nutritional supplements in head and neck cancer patients undergoing radiotherapy[J].Radiother Oncol, 2018, 126(1): 81-88.DOI: 10.1016/j.radonc.2017.10.015. [42] PACCAGNELLA A, MORELLO M, DA MOSTO M C, et al.Early nutritional intervention improves treatment tolerance and outcomes in head and neck cancer patients undergoing concurrent chemoradiotherapy[J].Support Care Cancer, 2010, 18(7): 837-845.DOI: 10.1007/s00520-009-0717-0. [43] KUBOTA K, KURODA J, YOSHIDA M, et al.Preoperative oral supplementation support in patients with esophageal cancer[J].J Nutr Health Aging, 2014, 18(4): 437-440.DOI: 10.1007/s12603-014-0018-2. [44] OBERMAIR A, SIMUNOVIC M, ISENRING L, et al.Nutrition interventions in patients with gynecological cancers requiring surgery[J].Gynecol Oncol, 2017, 145(1): 192-199.DOI: 10.1016/j.ygyno.2017.01.028. [45] 刘发强, 路晓林, 常迎彬.结直肠癌患者急诊手术后口服营养补充剂的临床效果[J].肿瘤防治研究, 2019, 46(7): 610-613.DOI: 10.3971/j.issn.1000-8578.2019.19.0529. [46] MENG L, WEI J, JI R, et al.Effect of early nutrition intervention on advanced nasopharyngeal carcinoma patients receiving chemoradiotherapy[J].J Cancer, 2019, 10(16): 3650-3656.DOI: 10.7150/jca.33475. [47] ADIAMAH A, SKOR ˇEPA P, WEIMANN A, et al.The impact of preoperative immune modulating nutrition on outcomes in patients undergoing surgery for gastrointestinal cancer: a systematic review and meta-analysis[J].Ann Surg, 2019, 270(2): 247-256.DOI: 10.1097/SLA.0000000000003256. [48] CHEN F, FANG J, WANG H, et al.Effects of nutritional support on short-term clinical outcomes and immune response in unresectable locally advanced oesophageal squamous cell carcinoma[J].Eur J Cancer Care(Engl), 2018, 27(2): e12818.DOI: 10.1111/ecc.12818. [49] BARKER L A, GRAY C, WILSON L, et al.Preoperative immunonutrition and its effect on postoperative outcomes in well-nourished and malnourished gastrointestinal surgery patients: a randomised controlled trial[J].Eur J Clin Nutr, 2013, 67(8): 802-807.DOI: 10.1038/ejcn.2013.117. [50] 邓桂芳, 李翠玉, 韦远欢, 等.术前口服营养补充对消化道恶性肿瘤病人营养状况及临床结局的影响[J].肠外与肠内营养, 2019, 26(4): 208-211.DOI: 10.16151/j.1007-810x.2019.04.004. [51] SORENSEN L S, THORLACIUS-USSING O, SCHMIDT E B, et al.Randomized clinical trial of perioperative Omega-3 fatty acid supplements in elective colorectal cancer surgery[J].Br J Surg, 2014, 101(2): 33-42.DOI: 10.1002/bjs.9361. [52] ACHILLI P, MAZZOLA M, BERTOGLIO C L, et al.Preoperative immunonutrition in frail patients with colorectal cancer: an intervention to improve postoperative outcomes[J].Int J Colorectal Dis, 2020, 35(1): 19-27.DOI: 10.1007/s00384-019-03438-4. [53] PREVOST V, GRACH M C.Nutritional support and quality of life in cancer patients undergoing palliative care[J].Eur J Cancer Care(Engl), 2012, 21(5): 581-590.DOI: 10.1111/j.1365-2354.2012.01363.x. [54] MENG Q Y, TAN S J, JIANG Y, et al.Post-discharge oral nutritional supplements with dietary advice in patients at nutritional risk after surgery for gastric cancer: a randomized clinical trial[J].Clin Nutr, 2021, 40(1): 40-46.DOI: 10.1016/j.clnu.2020.04.043. [55] 丁慧萍, 窦圣金, 汪琼, 等.口服营养补充对鼻咽癌同期放化疗患者的影响[J].中国癌症杂志, 2018, 28(1): 62-68.DOI: 10.19401/j.cnki.1007-3639.2018.01.009. [56] LIM S L, ONG K C, CHAN Y H, et al.Malnutrition and its impact on cost of hospitalization, length of stay, readmission and 3-year mortality[J].Clin Nutr, 2012, 31(3): 345-350.DOI: 10.1016/j.clnu.2011.11.001. [57] GRANT W B, MOUKAYED M.Vitamin D3 from ultraviolet-B exposure or oral intake in relation to cancer incidence and mortality[J].Curr Nutr Rep, 2019, 8(3): 203-211.DOI: 10.1007/s13668-019-0262-5. [58] SCHUETZ P, FEHR R, BAECHLI V, et al.Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial[J].Lancet, 2019, 393(10188): 2312-2321.DOI: 10.1016/S0140-6736(18)32776-4. [59] TAN S J, MENG Q Y, JIANG Y, et al.Impact of oral nutritional supplements in post-discharge patients at nutritional risk following colorectal cancer surgery: a randomised clinical trial[J].Clin Nutr, 2021, 40(1): 47-53.DOI: 10.1016/j.clnu.2020.05.038. [60] MELLO A T, BORGES D S, DE LIMA L P, et al.Effect of oral nutritional supplements with or without nutritional counselling on mortality, treatment tolerance and quality of life in head-and-neck cancer patients receiving(chemo)radiotherapy: a systematic review and meta-analysis[J].Br J Nutr, 2021, 125(5): 530-547.DOI: 10.1017/S0007114520002329. [61] SÖDERSTRÖM L, ROSENBLAD A, BERGKVIST L, et al.Dietary advice and oral nutritional supplements do not increase survival in older malnourished adults: a multicentre randomised controlled trial[J].Ups J Med Sci, 2020, 125(3): 240-249.DOI: 10.1080/03009734.2020.1751752. [62] ELIA M, VAN BOKHORST-DE VAN DER SCHUEREN M A, GARVEY J, et al.Enteral(oral or tube administration)nutritional support and eicosapentaenoic acid in patients with cancer: a systematic review[J].Int J Oncol, 2006, 28(1): 5-23.DOI: 10.3892/ijo.28.1.5. [63] LIDORIKI I, SCHIZAS D, MYLONAS K S, et al.Oral nutritional supplementation following upper gastrointestinal cancer surgery: a prospective analysis exploring potential barriers to compliance[J].J Am Coll Nutr, 2020, 39(7): 650-656.DOI: 10.1080/07315724.2020.1723453. [64] 何平, 许可敏, 刘江南, 等.口服营养补充依从性的影响因素[J].肿瘤代谢与营养电子杂志, 2017, 4(2): 232-241.DOI: 10.16689/j.cnki.cn11-9349/r.2017.02.021. [65] HUBBARD G P, ELIA M, HOLDOWAY A, et al.A systematic review of compliance to oral nutritional supplements[J].Clin Nutr, 2012, 31(3): 293-312.DOI: 10.1016/j.clnu.2011.11.020. [66] LILJEBERG E, ANDERSSON A, BLOM MALMBERG K, et al.High adherence to oral nutrition supplements prescribed by dietitians: a cross-sectional study on hospital outpatients[J].Nutr Clin Pract, 2019, 34(6): 887-898.DOI: 10.1002/ncp.10243. |
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