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Traitement pharmacologique de l’anorexie et de la cachexie chez les patients porteurs d’un cancer du tractus digestif

Pharmacological management of anorexia and cachexia in gastrointestinal cancer patients

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Résumé

L’anorexie et la cachexie surviennent fréquemment chez des patients à un stade avancé de cancer du tractus digestif. Une alimentation réduite et une augmentation des dépenses énergétiques sont les principales causes de ce syndrome clinique. De plus, la perturbation de plusieurs hormones de même que les cytoxines jouent un rôle étiologique majeur. Dans la plupart des cas, le traitement des patients cancéreux anorexiques/cachectiques est infructueux même si une aliméntation parentérale ou entérale est installée. Les corticoïdes apportent seulement un bénéfice subjectif de durée brève. Les agents progestationnels peuvent stimuler l’appétit et augmenter le poids. De nouveaux agents tels les acides gras omega-3 ou les anticorps anti-cytokines semblent très prometteurs bien qu’à terme, leur efficacité n’ait pas encore été démontrée.

Summary

Anorexia and cachexia are frequent findings in advanced G.I. cancer patients. Decreased food intake and increased energy expenditure are the major causes of this clinical syndrome. Moreover impairment of several hormones as well as cytokines play a major aetiological role.

The management of patients with cancer anorexia/cachexia remains unsuccessful in most cases, even with enteral or parenteral nutrition. Corticosteroids provide only short-term subjective benefit. Progestational agents can stimulate appetite and increase body weight. Newer agents, such as omega-3-fatty acids or anti-cytokine antibodies, appear very promising, even though a final evidence of their efficacy has not been proved.

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Correspondence to F. Frascio.

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Frascio, F., Giacosa, A. Traitement pharmacologique de l’anorexie et de la cachexie chez les patients porteurs d’un cancer du tractus digestif. Acta Endosc 31, 509–514 (2001). https://doi.org/10.1007/BF03023589

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Mots-clés

  • anorexie
  • cachexie
  • cancer digestif
  • traitement

Key-words

  • anorexia
  • cachexia
  • gastrointestinal cancer
  • therapy