Sažetak (engleski) | Cancers of the colon and rectum together are second most common tumor type worldwide.
The prognosis for the survival after disease progression is usually poor (1). Cancer anorexiacachexia
syndrome is highly prevalent among patients with colorectal cancer, and has a
large impact on morbidity and mortality, and on patient quality of life. Early intervention
with nutritional supplementation has been shown to halt malnutrition, and may improve
outcome in some patients (2).
The etiology of cancer-associated malnutrition appears to be related to the pathological loss
of inhibitory control of catabolic pathways, whose increased activities are not
counterbalanced by the increased central and peripheral anabolic drive (3).
The goals of nutritional support in patients with colorectal cancer are to improve nutritional
status to allow initiation and completion of active anticancer therapies (chemotherapy and
or radiotherapy) and improve quality of life (3, 4).
Cancer growth and dissemination but also cancer treatments, including surgery,
chemotherapy, and radiation therapy, interfere with taste, ingestion, swallowing, and digest
food which leads to hypophagia. Also, chemotherapy agents may cause nausea and
diarrhea (3, 4). Although many new agents are on the market to combat these symptoms,
prevalence of colorectal cancer is still high (1).
We studied the influence of nutritional support (counseling, nutritional supplements,
megestrol acetate) on physical status and symptoms in patients with colorectal cancer
during chemotherapy. The study was designed to investigate whether dietary counseling or
oral nutrition commercial supplements during chemotherapy and/or BSC affected nutritional status and influence survival status prevalence in patients with colorectal cancer.
Results: Three hundred and eighty-eight colorectal cancer patients were included in the
study. Nottingham Screening Tool Questionnaire, Appetite Loss Scale and Karnofsky
Performance Status were taken to evaluate the nutritive status of patients. Group I consisted
of 215 patients who were monitored prospectively and were given nutritional support and
in this group weight gain of 1,5 kg (0,6-2,8 kg) and appetite improvement was observed in
patients with colorectal cancer. In both groups Karnofsky Performance Status didn’t change
significantly reflecting the impact of the disease itself.
Nutritional counseling, supplemental feeding and pharmacological support do temporarily
stop weight loss and improve appetite, QoL and social life, but this improvement has no
implications on patients KPS and course of their disease.
Conclusion: These results encourage further studies with more specific nutritional
supplementation in patients with colorectal cancer and probably in gastrointestinal
oncology. |