Non-surgical oncology – Guidelines on Parenteral Nutrition, Chapter 19Nichtchirurgische Onkologie – Leitlinie Parenterale Ernährung, Kapitel 19

GMS German Medical Science — an Interdisciplinary Journal

A. Zander⁷  E. Shang⁵  I. Schmid⁴  M. Hug²  R. Fietkau³  A. Dossett¹  G. Zuercher⁶  J. Arends¹ 

[1] Dept. of Medical Oncology, Tumour Biology Center, University of Freiburg, Germany;Pharmacy, University Hospital Freiburg, Germany;Depts. Paediatric Surgery and Radiation Therapy, University of Rostock, Germany;Dept. Metabolic Diseases & Nutritional Medicine, Dr. von Hauner Children's Hospital, University of Munich, Germany;Dept Surgery, University Hospital of Mannheim, Germany;Dept. of Internal Medicine I, University of Freiburg, Germany;Dept. of Oncology and Haematology, University of Hamburg, Germany

关键词: stem cell transplantation;    chemotherapy;    radiotherapy;    tumour;   

Others  :  869131

实施日期：2009-01-14，发布日期：2009-11-18

【 摘 要 】

Reduced nutritional state is associated with unfavourable outcomes and a lower quality of life in patients with malignancies. Patients with active tumour disease frequently have insufficient food intake. The resting energy expenditure in cancer patients can be increased, decreased, or remain unchanged compared to predicted values. Tumours may result in varying degrees of systemic pro-inflammatory processes with secondary effects on all significant metabolic pathways. Therapeutic objectives are to stabilise nutritional state with oral/enteral nutrition and parenteral nutrition (PN) and thus to prevent or reduce progressive weight loss. The maintenance or improvement of quality of life, and the increase in the effectiveness and a reduction in the side-effects of antitumor therapy are further objectives. Indications for PN in tumour patients are essentially identical to those in patients with benign illnesses, with preference given to oral or enteral nutrition when feasible. A combined nutritional concept is preferred if oral or enteral nutrition are possible but not sufficient. There are generally no accepted standards for ideal energy and nutrient intakes in oncological patients, particularly when exclusive artificial nutrition is administered. The use of PN as a general accompaniment to radiotherapy or chemotherapy is not indicated, but PN is indicated in chronic severe radiogenic enteritis or after allogenic transplantation with pronounced mucositis or GvH-related gastrointestinal damage for prolonged periods, with particular attention to increased risk of bleeding and infection. No PN is necessary in the terminal phase.

【 授权许可】

   
© 2009 Arends et al.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

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