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Auswirkungen der Kachexie aus medizinischer Sicht

  • Jann Arenas

Zusammenfassung

Eine Mangelernährung, die mit oder ohne Vorhandensein einer Kachexie auftritt, ist bei Tumorpatienten oft mit bestimmten Symptomen, belastenden Beschwerden sowie ungünstigen Veränderungen des Erkrankungsverlaufs verbunden. Dabei ist bisher nicht klar, ob diese Begleiterscheinungen durch die Mangelernährung ausgelöst (kausaler Zusammenhang) oder begünstigt werden (permissiver Effekt). Unabhängig davon können sie auch lediglich parallele Folgen eines auslösenden Krankheitsprozesses sein, ohne in einem Ursache-Wirkungs-Zusammenhang mit der Mangelernährung zu stehen.

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Literatur

  1. 1.
    Arends J. Mangelernährung bei Tumorpatienten. Onkologe 2008;14:9–14.Google Scholar
  2. 2.
    Arends J, Bachmann P, Baracos V, et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr 2017;36:11–48.Google Scholar
  3. 3.
    Bozzetti F. Nutritional support of the oncology patient. Crit Rev Oncol Hematol 2013;87:172–200.Google Scholar
  4. 4.
    Cahill GF. Starvation in man. N Engl J Med 1970;282:668–675.Google Scholar
  5. 5.
    Cederholm T, Bosaeus I, Barazzoni R, et al.Diagnostic criteria for malnutrition – An ESPEN Consensus Statement. Clin Nutr 2015;34:335–340.Google Scholar
  6. 6.
    Chandra RK. Nutrition and the immune system: an introduction. Am J Clin Nutr 1997;66:460S–463S.Google Scholar
  7. 7.
    Evans WJ, Morley JE, Argilés J, et al. Cachexia: a new definition. Clin Nutr 2008;27:793–799.Google Scholar
  8. 8.
    Faber J, Vos AP, Kegler D, et al. Impaired immune function: an early marker for cancer cachexia. Oncol Rep 2009;22:1403–1406.Google Scholar
  9. 9.
    Fearon K, Strasser F, Anker SD, et al. Definition and classification of cancer cachexia: an international consensus. Lancet Oncol 2011;12:489–495.Google Scholar
  10. 10.
    França TGD, Ishikawa LLW, Zorzella-Pezavento SFG, Chiuso-Minicucci F, da Cunha M, Sartori A.Impact of malnutrition on immunity and infection. J Venom Anim Toxins Trop Dis 2009;15:374–390.Google Scholar
  11. 11.
    Girish M, Bhattad S, Ughade S, Mujawar N, Gaikwad K. Physical activity as a clinical tool in the assessment of malnutrition. Indian Pediatr 2014;51:478–480.Google Scholar
  12. 12.
    Grande AJ, Silva V, Maddocks M. Exercise for cancer cachexia in adults: Executive summary of a Cochrane Collaboration systematic review. J Cachexia Sarcopenia Muscle 2015;6:208–211.Google Scholar
  13. 13.
    Haran PH, Rivas DA, Fielding RA. Role and potential mechanisms of anabolic resistance in sarcopenia. J Cachexia Sarcopenia Muscle 2012;3:157–162.Google Scholar
  14. 14.
    Haus JM, Carrithers JA, Carroll CC, et al. Contractile and connective tissue protein content of human skeletal muscle: effects of 35 and 90 days of simulated microgravity and exercise countermeasures. Am J Physiol – Regul Integr Comp Physiol 2007;293:R1722–R1727.Google Scholar
  15. 15.
    Hopkinson JB. The emotional aspects of cancer anorexia. Curr Opin Support Palliat Care 2010;4:254–258.Google Scholar
  16. 16.
    Hopkinson JB. Psychosocial impact of cancer cachexia. J Cachexia Sarcopenia Muscle 2014;5:89–94.Google Scholar
  17. 17.
    Horneber M, Fischer I, Dimeo F, Rüffer J, Weis J. Tumor-assoziierte Fatigue: Epidemiologie, Pathogenese, Diagnostik und Therapie. Dtsch Ärztebl Int 2012;109:161–172.Google Scholar
  18. 18.
    Jensen GL, Mirtallo J, Compher C, et al. Adult starvation and disease-related malnutrition: a proposal for etiology-based diagnosis in the clinical practice setting from the International Consensus Guideline Committee. Clin Nutr Edinb Scotl 2010;29:151–153.Google Scholar
  19. 19.
    Khalid U, Spiro A, Baldwin C, et al. Symptoms and weight loss in patients with gastrointestinal and lung cancer at presentation. Support Care Cancer Off J Multinatl Assoc Support Care Cancer 2007;15:39–46.Google Scholar
  20. 20.
    Knox LS, Crosby LO, Feurer ID, Buzby GP, Miller CL, Mullen JL. Energy expenditure in malnourished cancer patients. Ann Surg 1983;197(2):152–162.Google Scholar
  21. 21.
    Laviano A, Meguid MM, Inui A, Muscaritoli M, Rossi-Fanelli F. Therapy insight: Cancer anorexia-cachexia syndrome – when all you can eat is yourself. Nat Clin Pract Oncol 2005;2:158–165.Google Scholar
  22. 22.
    Lis CG, Gupta D, Grutsch JF. Can anorexia predict patient satisfaction with quality of life in advanced cancer? Support Care Cancer 2009;17:129–135.Google Scholar
  23. 23.
    Löser C.Malnutrition in hospital – the clinical and economic implications. Dtsch Ärztebl Int 2010;107:911–917.Google Scholar
  24. 24.
    Martin L, Senesse P, Gioulbasanis I, et al. Diagnostic criteria for the classification of cancer-associated weight loss. J Clin Oncol 2015;33:90–99.Google Scholar
  25. 25.
    Masrizal MA. Effects of protein-energy malnutrition on the immune system. Makara Sains 2003;7:69–73.Google Scholar
  26. 26.
    McMillan DC. The systemic inflammation-based Glasgow Prognostic Score: a decade of experience in patients with cancer. Cancer Treat Rev 2013;39:534–540.Google Scholar
  27. 27.
    Morley JE, Abbatecola AM, Argiles JM, et al. Sarcopenia with limited mobility: an international consensus. J Am Med Dir Assoc 2011;12:403–409.Google Scholar
  28. 28.
    Moses AWG, Slater C, Preston T, Barber MD, Fearon KCH. Reduced total energy expenditure and physical activity in cachectic patients with pancreatic cancer can be modulated by an energy and protein dense oral supplement enriched with n-3 fatty acids. Br J Cancer 2004;90:996–1002.Google Scholar
  29. 29.
    Mustian KM, Peppone LJ, Palesh OG, et al. Exercise and Cancer-related Fatigue. US Oncol 2009;5:20–23.Google Scholar
  30. 30.
    Nguyen TYV, Batterham MJ, Edwards C. Comparison of Resting Energy Expenditure Between Cancer Subjects and Healthy Controls: A Meta-Analysis. Nutr Cancer 2016;68:374–387.Google Scholar
  31. 31.
    Norman K, Pichard C, Lochs H, Pirlich M. Prognostic impact of disease-related malnutrition. Clin Nutr Edinb Scotl 2008;27:5–15.Google Scholar
  32. 32.
    Omlin A, Blum D, Wierecky J, Haile SR, Ottery FD, Strasser F. Nutrition impact symptoms in advanced cancer patients: frequency and specific interventions, a case-control study. J Cachexia Sarcopenia Muscle 2013;4:55–61.Google Scholar
  33. 33.
    Prado CMM. Body composition in chemotherapy: the promising role of CT scans. Curr Opin Clin Nutr Metab Care 2013;16:525–533.Google Scholar
  34. 34.
    Prado CMM, Lieffers JR, McCargar LJ, et al. Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: a population-based study. Lancet Oncol 2008;9:629–635.Google Scholar
  35. 35.
    Ravasco P, Monteiro-Grillo I, Vidal PM, Camilo ME. Cancer: disease and nutrition are key determinants of patients' quality of life. Support Care Cancer 2004;12:246–252.Google Scholar
  36. 36.
    Strasser F. Eating-related disorders in patients with advanced cancer. Support Care Cancer 2003;11:11–20.Google Scholar
  37. 37.
    Strasser F, Binswanger J, Cerny T, Kesselring A. Fighting a losing battle: eating-related distress of men with advanced cancer and their female partners. A mixed-methods study. Palliat Med 2007;21:129–137.Google Scholar
  38. 38.
    Tong H, Isenring E, Yates P. The prevalence of nutrition impact symptoms and their relationship to quality of life and clinical outcomes in medical oncology patients. Support Care Cancer 2009;17:83–90.Google Scholar
  39. 39.
    Valentini L, Volkert D, Schütz T, et al. Leitlinie der Deutschen Gesellschaft für Ernährungsmedizin (DGEM): DGEM-Terminologie in der Klinischen Ernährung. Aktuelle Ernaehrungsmedizin 2013;38:97–111.Google Scholar
  40. 40.
    Wallengren O, Lundholm K, Bosaeus I. Diagnostic criteria of cancer cachexia: relation to quality of life, exercise capacity and survival in unselected palliative care patients. Support Care Cancer 2013;21:1569–1577.Google Scholar
  41. 41.
    Walsh D, Donnelly S, Rybicki L. The symptoms of advanced cancer: relationship to age, gender, and performance status in 1,000 patients. Support Care Cancer 2000;8(3):175–179.Google Scholar
  42. 42.
    Waterhouse C, Kemperman JH. Carbohydrate metabolism in subjects with cancer. Cancer Res 1971;31:1273–1278.Google Scholar
  43. 43.
    Winter A, MacAdams J, Chevalier S. Normal protein anabolic response to hyperaminoacidemia in insulin-resistant patients with lung cancer cachexia. Clin Nutr 2012;31:765–773.Google Scholar
  44. 44.
    Zhou T, Yang K, Thapa S, Liu H, Wang B, Yu S. Differences in symptom burden among cancer patients with different stages of cachexia. J Pain Symptom Manage 2017;53:919–926.Google Scholar

Copyright information

© Springer Medizin Verlag GmbH, München 2017

Authors and Affiliations

  • Jann Arenas
    • 1
  1. 1.Universitätsklinikum FreiburgFreiburgDeutschland

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