がんの臨床栄養と身体組成

がんの臨床栄養と身体組成に関するレビュー論文を紹介します。

Nathalie Jacquelin-Ravela, Claude Pichard. Clinical nutrition, body composition and oncology: A critical literature review of the synergies. Critical Reviews in Oncology/Hematology http://dx.doi.org/10.1016/j.critrevonc.2012.02.001

図のように悪液質とサルコペニアの違いを明確に解説していますし、悪液質の定義はEPCRC、ESPEN、Evansらの3つを紹介しています。わかりやすくて読む価値のあるレビュー論文だと考えます。まだ全部読めていませんが…。

単なる体重減少だけでなく身体組成の結果に基づいて栄養状態を評価すべきです。身体組成は体表面積よりも化学療法時の薬剤の量を決めるのに正確です。サルコペニアは抗がん剤毒性の唯一有意な予測因子です。身体組成はがん治療に影響を与えます。

Abstract

Purpose of the research
Review the oncology and clinical nutrition literature to highlight the synergies between those two subjects. This review focuses on diagnostic of lean body wasting and the recent improvements in measuring body composition to monitor the response to nutrition during optimal oncology treatment.

Principal results Nutrition support in cancer patients has made major progresses. A variety of advanced tools allow monitoring and explaining weight loss, body composition changes and metabolic alterations. Body composition is more accurate than body surface area to determine chemotherapeutic drug dosing. As with any therapeutic approach, clinical nutrition has a better risk-benefit ratio if implemented when indicated rather than used routinely. Body composition measurements are helpful for a better understanding of the host-tumor interactions during cancer treatment and nutrition support.

Major conclusions Nutrition support based on body composition analysis may significantly contribute to optimize current oncology treatment and clinical outcomes.

Highlights ► Body composition should replace weight loss to define the nutritional status. ► Obesity and cachexia may occur simultaneously. ► Sarcopenia is the only significant predictor of chemotoxicity. ► Body composition techniques have a demonstrated positive impact in cancer treatment. ► Nutrition is not a routine care, needs to be patient-specific and fine-tuned.