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InFo Hämatologie + Onkologie

, Volume 22, Issue 11, pp 31–36 | Cite as

Schwerpunkt Pankreaskarzinom

Gezielte Ernährung beim Pankreaskarzinom — auf keinen Fall vernachlässigen!

  • Stephan SchornEmail author
  • Helmut Friess
  • Marc Martignoni
Schwerpunkt

Die Mehrzahl der Patienten mit Pankreaskarzinom leidet unter einer Mangelernährung, die sich als Sarkopenie und/oder Tumorkachexie manifestiert. Diese Mangelernährung schränkt nicht nur die Lebensqualität der Betroffenen stark ein, sondern reduziert auch die Überlebenschancen. Wie es dazu kommt und was sich dagegen tun lässt, lesen Sie in der vorliegenden Übersicht.

Literatur

  1. 1.
    Neoptolemos JP et al. Adjuvant chemoradiotherapy and chemotherapy in resectable pancreatic cancer: a randomised controlled trial. Lancet. 2001;358(9293):1576–85CrossRefGoogle Scholar
  2. 2.
    Neoptolemos JP et al. Comparison of adjuvant gemcitabine and capecitabine with gemcitabine monotherapy in patients with resected pancreatic cancer (ESPAC-4): a multicentre, open-label, randomised, phase 3 trial. Lancet. 2017;389(10073):1011–24CrossRefGoogle Scholar
  3. 3.
    He J et al. 2564 resected periampullary adenocarcinomas at a single institution: trends over three decades. HPB (Oxford). 2014;16(1):83–90CrossRefGoogle Scholar
  4. 4.
    Dhir M et al. FOLFIRINOX Versus Gemcitabine/Nab-Paclitaxel for Neoadjuvant Treatment of Resectable and Borderline Resectable Pancreatic Head Adenocarcinoma. Ann Surg Oncol. 2018;25(7):1896.903CrossRefGoogle Scholar
  5. 5.
    Conroy T et al. FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N Engl J Med. 2011;364(19):1817–25CrossRefGoogle Scholar
  6. 6.
    Miyasaka Y et al. Neoadjuvant Chemotherapy with Gemcitabine Plus Nab-Paclitaxel for Borderline Resectable Pancreatic Cancer Potentially Improves Survival and Facilitates Surgery. Ann Surg Oncol. 2019;26(5):1528–34CrossRefGoogle Scholar
  7. 7.
    Conroy T et al. FOLFIRINOX or Gemcitabine as Adjuvant Therapy for Pancreatic Cancer. N Engl J Med. 2018;379(25):2395–406CrossRefGoogle Scholar
  8. 8.
    Fearon KC, Baracos VE. Cachexia in pancreatic cancer: new treatment options and measures of success. HPB (Oxford). 2010;12(5):323–4.CrossRefGoogle Scholar
  9. 9.
    Fearon K et al. Understanding the mechanisms and treatment options in cancer cachexia. Nat Rev Clin Oncol. 2013;10(2):90–9CrossRefGoogle Scholar
  10. 10.
    Murry DJ et al. Impact of nutrition on pharmacokinetics of anti-neoplastic agents. Int J Cancer Suppl. 1998;11:48–51CrossRefGoogle Scholar
  11. 11.
    Andreyev HJ et al. Why do patients with weight loss have a worse outcome when undergoing chemotherapy for gastrointestinal malignancies? Eur J Cancer. 1998;34(4):503–9CrossRefGoogle Scholar
  12. 12.
    Lis CG et al. Role of nutritional status in predicting quality of life outcomes in cancer—a systematic review of the epidemiological literature. Nutr J. 2012;11:27CrossRefGoogle Scholar
  13. 13.
    Schneider SM et al. Malnutrition is an independent factor associated with nosocomial infections. Br J Nutr. 2004;92(1):105–11CrossRefGoogle Scholar
  14. 14.
    Dewys WD et al. Prognostic effect of weight loss prior to chemotherapy in cancer patients. Eastern Cooperative Oncology Group. Am J Med. 1980;69(4):491–7CrossRefGoogle Scholar
  15. 15.
    Ozola Zalite I et al. Influence of cachexia and sarcopenia on survival in pancreatic ductal adenocarcinoma: a systematic review. Pancreatology. 2015;15(1):19–24CrossRefGoogle Scholar
  16. 16.
    Bachmann J et al. Cachexia in patients with chronic pancreatitis and pancreatic cancer: impact on survival and outcome. Nutr Cancer. 2013;65(6):827–33CrossRefGoogle Scholar
  17. 17.
    Bachmann J et al. Cachexia worsens prognosis in patients with resectable pancreatic cancer. J Gastrointest Surg. 2008;12(7):1193–201.CrossRefGoogle Scholar
  18. 18.
    Martignoni ME et al. Cancer cachexia. Mol Cancer. 2003;2:36CrossRefGoogle Scholar
  19. 19.
    Mueller TC et al. Cachexia and pancreatic cancer: are there treatment options? World J Gastroenterol. 2014;20(28):9361–73PubMedPubMedCentralGoogle Scholar
  20. 20.
    Fearon K et al. Definition and classification of cancer cachexia: an international consensus. Lancet Oncol. 2011;12(5):489–95CrossRefGoogle Scholar
  21. 21.
    Bozzetti F et al. ESPEN Guidelines on Parenteral Nutrition: non-surgical oncology. Clin Nutr. 2009;28(4):445–54CrossRefGoogle Scholar
  22. 22.
    Fearon KC. Cancer cachexia: developing multimodal therapy for a multidimensional problem. Eur J Cancer. 2008;44(8):1124–32.CrossRefGoogle Scholar
  23. 23.
    Prado CM et al. An exploratory study of body composition as a determinant of epirubicin pharmacokinetics and toxicity. Cancer Chemother Pharmacol. 2011;67(1):93–101CrossRefGoogle Scholar
  24. 24.
    Prado CM et al. Two faces of drug therapy in cancer: drug-related lean tissue loss and its adverse consequences to survival and toxicity. Curr Opin Clin Nutr Metab Care. 2011;14(3):250–4CrossRefGoogle Scholar
  25. 25.
    Choi Y et al. Skeletal Muscle Depletion Predicts the Prognosis of Patients with Advanced Pancreatic Cancer Undergoing Palliative Chemotherapy, Independent of Body Mass Index. PLoS One. 2015;10(10):e0139749CrossRefGoogle Scholar
  26. 26.
    Basile D et al. The IMPACT study: early loss of skeletal muscle mass in advanced pancreatic cancer patients. J Cachexia Sarcopenia Muscle. 2019;10(2):368–77CrossRefGoogle Scholar
  27. 27.
    Schuetz P et al. Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial. The Lancet. 2019;393(10188):2312–21CrossRefGoogle Scholar
  28. 28.
    Morley JE. Calories and cachexia. Curr Opin Clin Nutr Metab Care. 2009;12(6):607–10CrossRefGoogle Scholar
  29. 29.
    Busquets S et al. L-Carnitine: an adequate supplement for a multi-targeted anti-wasting therapy in cancer. Clin Nutr. 2012;31(6):889–95CrossRefGoogle Scholar
  30. 30.
    Loprinzi CL et al. Randomized comparison of megestrol acetate versus dexamethasone versus fluoxymesterone for the treatment of cancer anorexia/cachexia. J Clin Oncol. 1999;17(10):3299–306CrossRefGoogle Scholar
  31. 31.
    Mantovani G et al. Phase II nonrandomized study of the efficacy and safety of COX-2 inhibitor celecoxib on patients with cancer cachexia. J Mol Med (Berl). 2010;88(1):85–92CrossRefGoogle Scholar
  32. 32.
    Wigmore SJ et al. Ibuprofen reduces energy expenditure and acute-phase protein production compared with placebo in pancreatic cancer patients. Br J Cancer. 1995;72(1):185–8CrossRefGoogle Scholar
  33. 33.
    Lundholm K et al. Evidence that long-term COX-treatment improves energy homeostasis and body composition in cancer patients with progressive cachexia. Int J Oncol. 2004;24(3):505–12PubMedGoogle Scholar

Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  • Stephan Schorn
    • 1
    Email author
  • Helmut Friess
    • 1
  • Marc Martignoni
    • 1
  1. 1.Klinik und Poliklinik für ChirurgieKlinikum rechts der Isar der TU MünchenMünchenDeutschland

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