The impact of clinical nutrition on cancer therapy: a frequently underestimated perspective. A complementary approach to cancer patients

摘要

Since the onset of the disease, oncologic patients frequently show a weight loss that varies according to cancer location, type and stage . The neoplastic diseases that mostly induce malnutrition are Hodgkin's lymphoma, gastrointestinal cancer, and head and neck tumors. Inversely related to prognosis, malnutrition causes a worsening in the quality of life, with an increase of morbidity and mortality. In a reasonable percentage of neoplastic patients, the first cause of death seems to be due more to a metabolic-nutritional unbalance than to the disease itself. In a recent French trial in 879 patients, Pressoir et al. has found that a moderate to severe malnutrition is related with extended periods of hospitalization: 19.3 ± 19.4 vs. 13.3 ± 19.4 days (P < 0.001). In 2010, Platek et al. demonstrated that in patients with head and neck tumors, who were undergoing an antiblastic treatment, >10 % pretreatment weight loss was related with an incomplete locoregional response. Moreover, in the univariate analysis, malnourished patients showed a worsened physical function (P = 0.007) and an increased fatigue (P -0.034) compared to well-nourished patients; in the multivariate analysis, instead, malnutrition was significantly related to physical function (P = 0.015) .