Wyniszczenie nowotworowe – przegląd możliwości terapeutycznych

Marta Wysocka

Streszczenie
Cancer cachexia is common clinical problem that substantially impacts upon the quality of life and survival of affected patients. It is the result of major metabolic changes produced by tumor-released substances as well as by cytokines and some endogenous peptides. Cachexia should be suspected in patients with cancer if an involuntary weight loss of grater than five percent of premorbid weight occurs within a six-month period. Aggressive parenteral nutrition has not been able to increase patients survival or produce any significant symptomatic improvement. Despite positive pilot trial reports, large randomized studies have been unable to demonstrate a clinically defensible role for either pentoxifylline, serotonin, or hydrazine for patients with anorexia. Corticosteroids have been shown to increase appetite for a brief period of time, but they do not appear to improve caloric intake or nutritional status. In comparison, multiple studies have demonstrated that the progestational agent, megestrol acetate, has both appetite-enhancing and weight-promoting properties. A new approach to the management of cachexia has been to combine the appetite-stimulating properties of a progestational agent with the anti-inflammatory properties of the NSAIDs by using megestrol and ibuprofen together.

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