肿瘤患者食欲评价和调节的专家共识

doi:10.16689/j.cnki.cn11-9349/r.2020.02.007

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Abstract Loss of appetite is a common symptom in cancer patients， and the incidence of cancer anorexia cachexia syndrome is higher in advanced cancer patients. Due to insufficient nutrition intake， cancer patients will suffer from pancytopenia， weight loss， loss of fat tissue and skeletal muscle， resulting in decreased immunity， decreased treatment tolerance， reduced treatment opportunities， and increased complications. These problems are not conducive to the implementation of anti-cancer treatment measures. Accurate assessment of the process of cancer anorexia is of great importance for both research and clinical treatment. Scientific methods and techniques of appetite assessment are not only tools for nutritionists to evaluate appetite objectively， but also the basis for further understanding and prediction of malnutrition， which have positive significance for improving malnutrition in cancer patients. According to the existing research evidence， this consensus systematically summarized the research results in this field. Starting from the relationship between tumor， nutrition and appetite， this paper analyzed the mechanism of the occurrence and development of cancer anorexia. We summarized the evaluation methods of appetite in tumor patients under different conditions and gave expert recommendations. Combined with the status and characteristics of diet in China， this paper proposed the methods of improving appetite from the perspectives of clinical practice， nutrition， nursing and traditional Chinese medicine. We scientifically standardized the management strategy of cancer anorexia， so as to facilitate the application of clinicians， clinical nutrition professionals， nurses and other medical care personnel to better serve the cancer patients.

Key words： Cancer Appetite Anorexia Evaluation Intervention

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http://182.92.200.144/EN/10.16689/j.cnki.cn11-9349/r.2020.02.007 OR http://182.92.200.144/EN/Y2020/V7/I2/169

1.BRAY F， FERLAY J， SOERJOMATARAM I， et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries［J］. CA Cancer J Clin， 2018， 68（6）: 394-424.
2.GIESINGER J M， WINTNER L M，OBERGUGGENBERGER A S， et al. Quality of life trajectory in patients with advanced cancer during the last year of life［J］. J Palliat Med， 2011， 14（8）: 904-912.
3.REEVE B B， MITCHELL S A， DUECK A C， et al. Recommended patient-reported core set of symptoms to measure in adult cancer treatment trials［J］.J Natl Cancer Inst， 2014， 106（7）: 1-8.
4.TRAJKOVIC-VIDAKOVIC M， GRAEFF A D， VOEST E E， et al. Symptoms tell it all: a systematic review of the value of symptom assessment to predict survival in advanced cancer patients［J］. Crit Rev Oncol Hematol， 2012， 84（1）: 130-148.
5.DAVIS M P， DREICER R， WALSH D， et al. Appetite and cancer-associated anorexia: a review［J］. J Clin Oncol， 2004， 22（8）: 1510-1517.
6.JOHANNES C M， MUSSER M L.Anorexia and the Cancer Patient［J］. Vet Clin North Am Small Anim Pract， 2019， 49（5） : 837-854.
7.BENNANI-BAITI N， WALSH D. What is cancer anorexia-cachexia syndrome? A historical perspective［J］. J R Coll Physicians of Edinb， 2009， 39（3）: 257-262.
8.MULIAWATI Y， HAROEN H， ROTTY L W. Cancer anorexia-cachexia syndrome［J］. Acta Med Indones， 2012， 44（2）: 154-162.
9.VAN LANCKER， AURLIE， VELGHE A， VAN Hecke A， et al. Prevalence of Symptoms in Older Cancer Patients Receiving Palliative Care: A Systematic Review and Meta-Analysis［J］. J Pain Symptom Manage， 2014， 47（1）: 90-104.
10.YAVUZSEN T， DAVIS M P， WALSH D， et al. Systematic review of the treatment of cancer-associated anorexia and weight loss［J］. J Clin Oncol， 2005， 23（33）: 8500-8511.
11.ALESSANDRO L， MEGUID M M， FILIPPO R F. Cancer anorexia: clinical implications， pathogenesis， and therapeutic strategies［J］. Lancet Oncol， 2003， 4（11）: 686-694.
12.TEUNISSEN S C C M， WESKER W， KRUITWAGEN C， et al. Symptom prevalence in patients with incurable cancer: a systematic review［J］. J Pain Symptom Manage， 2007， 34（1）: 94-104.
13.LEVY M H， ANTHONY B， COSTANTINO B， et al. NCCN clinical practice guidelines in oncology: palliative care［J］. J Natl Compr Canc Netw， 2009， 7（4）: 436-473.
14.SHRAGGE J E， WISMER W V， OLSON K L， et al. The management of anorexia by patients with advanced cancer: a critical review of the literature［J］. Palliat Med， 2006， 20（6）: 623-629.
15.DAVIS M P， DICKERSON E D. Cachexia and anorexia: cancer’s covert killer［J］. Support Care Cancer， 2000， 8（3）: 180-187.
16.FINCK B N， JOHNSON R W. Tumor necrosis factor-alpha regulates secretion of the adipocyte-derived cytokine， leptin［J］. Microsc Res Tech， 2000， 50（3）: 209-215.
17.侯晓华，徐三平，李彩丽. 肿瘤患者摄食减少的机制［J］. 国际消化病杂志， 2005， 25（4）: 245-247.
18.DAVIS M P， DREICER R， WALSH D， et al. Appetite and cancer-associated anorexia: a review［J］. J Clin Oncol， 2004， 22（8）: 1510-1517.
19.陈振东，张林杰. 癌症食欲不振/恶病质综合征发病机制及其治疗的研究进展［J］. 国际肿瘤学杂志， 1997，（4）: 243-245.
20.AARONSON N K， AHMEDZAI S， BERGMAN B， et al. The european organization for research and treatment of cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst， 1993， 85（5）: 365-376.
21.OGAMA N， SUZUKI S， UMESHITA K， et al. Appetite and adverse effects associated with radiation therapy in patients with head and neck cancer. Eur J Oncol Nurs， 2010， 14（1）: 3-10.
22.GRIMSTIEGER M， KEILANI M， MADER R M， et al. Serum levels of tumour necrosis factor-alpha and interleukin-6 and their correlation with body mass index， weight loss， appetite and survival rate--preliminary data of Viennese outpatients with metastatic cancer during palliative chemotherapy［J］. Eur J Cancer Care， 2008， 17（5）: 454-462.
23.FLINT A， RABEN A， BLUNDELL J E， et al. Reproducibility， power and validity of visual analogue scales in assessment of appetite sensations in single test meal studies［J］. Int J Obes Relat Metab Disord， 2000， 24（1）: 38-48.
24.GIBBONS C， CAUDWELL P， FINLAYSON G， et al. Validation of a new hand-held electronic data capture method for continuous monitoring of subjective appetite sensations［J］. Int J Behav Nutr Phys Act， 2011， 8（1）: 57.
25.BRUNGER L， SMITH A， RE R， et al. Validation of an iPad visual analogue rating system for assessing appetite and satiety［J］. Appetite， 2015， 84: 259-263.
26.RIBAUDO J M， CELLA D， HAHN E A， et al. Re-validation and shortening of the Functional Assessment of Anorexia/Cachexia Therapy （FAACT） questionnaire［J］. Qual life Res， 2000， 9（10）: 1137-1146.
27.GELHORN H L， GRIES K S， SPECK R M， et al. Comprehensive validation of the functional assessment of anorexia/cachexia therapy （FAACT） anorexia/cachexia subscale （A/CS） in lung cancer patients with involuntary weight loss［J］. Quality of Life Research， 2019.
28.VAN DER M B S， SCHOONBEEK C P， SMIT E F， et al. Pre-cachexia and cachexia at diagnosis of stage Ⅲ non-small-cell lung carcinoma: an exploratory study comparing two consensus-based frameworks［J］. Br J Nutr， 2013， 109（12）: 2231-2239.
29.BLUM D， OMLIN A， FEARON K， et al. Evolving classification systems for cancer cachexia: ready for clinical practice?［J］. Support Care Cancer， 2010， 18（3）: 273-279.
30.BLAUWHOFF-BUSKERMOLEN S，RUIJGROK C，OSTELO R W， et al. The assessment of anorexia in patients with cancer: cut-off values for the FAACT-A/CS and the VAS for appetite［J］. Support Care Cancer， 2016， 24（2）: 661-666.
31.DAVIS M P， YAVUZSEN T， KIRKOVA J， et al. Validation of a simplified anorexia questionnaire［J］.J Pain Symptom Manage， 2009， 38（5）: 691-697.
32. HALLIDAY V， POROCK D， ARTHUR A， et al. Development and testing of a cancer appetite and symptom questionnaire［J］. J Hum Nutr Diet， 2012， 25（3）: 217-224.
33.SPEXOTO M C B， SERRANO S V， HALLIDAY V， et al. Cancer Appetite and Symptom Questionnaire （CASQ） for Brazilian Patients: Cross-Cultural Adaptation and Validation Study［J］. PLoS One， 2016， 11（6）: e0156288.
34.杜红珍. 中文版肿瘤患者食欲症状问卷信度、效度分析［J］.肿瘤代谢与营养电子杂志， 2017，（4）: 120-124.
35.OGAMA N， OGAMA N. Development of an oral assessment tool to evaluate appetite in patients with head and neck cancer receiving radiotherapy［J］. Eur J Oncol Nurs， 2013， 17（4）: 474-481.
36.INUI A. Cancer anorexia-cachexia syndrome: current issues in research and management［J］. CA Cancer J Clin， 2002， 52（2）: 72-91.
37.ARBOGAST L A， VOOGT J L. Progesterone induces dephosphorylation and inactivation of tyrosine hydroxylase in rat hypothalamic dopaminergic neurons［J］. Neuroendocrinology， 2002， 75（5）: 273-281.
38.PARKER S L， CARROLL B L， KALRA S P，et al. Neuropeptide Y Y2 receptors in hypothalamic neuroendocrine areas are up-regulated by estradiol and decreased by progesterone cotreatment in the ovariectomized rat［J］. Endocrinology， 1996， 137（7）: 2896-2900.
39.LAMBERT C P， SULLIVAN D H， FREELING S A， et al. Effects of Testosterone Replacement and/or Resistance Exercise on the Composition of Megestrol Acetate Stimulated Weight Gain in Elderly Men: A Randomized Controlled Trial［J］. J Clin Endocrinol Metab， 2002， 87（5）: 2100-2106.
40.崔岩岩，贾玫.癌性厌食的治疗［J］.中国临床医生杂志， 2017， 45（4）: 6-8.
41.GARCIA V R， EDUARDO LPEZ-BRIZ， SANCHIS R C， et al. Megestrol acetate for treatment of anorexia-cachexia syndrome［J］.Cochrane Database Syst Rev， 2013， 28（3）: CD004310.
42.耿宝琴.肿瘤恶病质的药物处理［J］.浙江实用医学， 2002， 7（3）: 131-133.
43.GAYLE D， ILYIN S E， PLATA-SALAMN C R. Central nervous system IL-1β system and neuropeptide Y mRNAs during IL-1β-induced anorexia in rats［J］. Brain Res Bull， 1997， 44（3）: 311-317.
44.DALLMAN M F， AKANA S F， STRACK A M， et al. The neural network that regulates energy balance is responsive to glucocorticoids and insulin and also regulates HPA axis responsivity at a site proximal to CRF neurons［J］. Ann N Y Acad Sci， 1995， 771（1）: 730-742.
45.YENNURAJALINGAM S， FRISBEE-HUME S， PALMER J L， et al. Reduction of cancer-related fatigue with dexamethasone: a double-blind， randomized， placebo-controlled trial in patients with advanced cancer［J］. J Clin Oncol， 2013， 31（25）: 3076-3082.
46.YAVUZSEN T， DAVIS M P， WALSH D， et al. Systematic review of the treatment of cancer-associated anorexia and weight loss［J］. J Clin Oncol， 2005， 23（33）: 8500-8511.
47.INUI A. Cancer anorexia-cachexia syndrome: current issues in research and management［J］. CA Cancer J Clin， 2002， 52（2）: 72-91.
48.JONATHAN W， JEAN-YVES P， DENISE M， et al. Long-term safety and clinical effectiveness of controlled-release metoclopramide in cancer-associated dyspepsia syndrome: a multicentre evaluation［J］. J Palliat Care， 2002， 18（2）: 84-91.
49.STRASSER F. Eating-related disorders in patients with advanced Cancer［J］.Support Care Cancer， 2003， 11 （1）: 11-20.
50.RAVASCO P， MONTEIRO GRILLO I， CAMILO M. Cancer wasting and quality of life react to early individualized nutritional counselling［J］. Clin Nutr， 2007， 26 （1）: 7-15.
51.RAMOS E J B， MIDDLETON F A， LAVIANO A， et al. Effects of omega-3 fatty acid supplementation on tumor-bearing rats［J］. J Am Coll Surg， 2004， 199（5）: 716-723.
52.WIGMORE S J， ROSS J A， FALCONER J S， et al. The effect of polyunsaturated fatty acids on the progress ofcachexia in patients with pancreatic cancer［J］. Nutrition， 1996， 12（1 Suppl）: 27-30.
53.张文富，林才志，陈泉芳，等. 秦家泰验方救必应汤治疗肺癌食欲不振—恶病质综合征临床观察［J］. 广西中医药， 2018， 41（6）: 12-13.
54.陶妍志，龙鑫，文静，等. 中药穴位贴敷治疗肺癌患者化疗后胃肠道反应的研究［J］. 现代中西医结合杂志， 2012， 21（26）: 2961-2962.
55.卢璐，符文彬，刘月，等. 艾灸对恶性肿瘤患者化疗前后生存质量影响的Meta分析［J］. 医学研究生学报， 2016， 29（1）: 75-82.
56.赵朝庭. 针刺改善癌性厌食恶病质综合征的临床研究［D］. 2016.
57.SHRAGGE J E， WISMER W V， OLSON K L， et al. The management of anorexia by patients with advanced cancer: a critical review of the literature［J］. Palliat Med， 2006， 20（6）: 623-629.