摘要
营养不良在肿瘤放射治疗(简称放疗)患者中发生率高,肿瘤放疗营养的核心理念是对肿瘤放疗患者的营养不良进行预防、诊断、治疗、评估和检测,从而降低放疗不良反应,增加放疗疗效。放疗对于营养是把双刃剑,具有正负两方面的效应。改善营养不良对肿瘤放疗具有重要的意义,能够显著提高肿瘤治疗疗效,延长总生存期。肿瘤放疗营养需要建立肿瘤放疗营养多学科团队(MDT),并且对肿瘤放疗营养的规范化诊断应结合患者主观整体营养评估(PG-SGA)评分和美国肿瘤放疗协作组(RTOG)放射损伤分级。肠内营养途径选择遵循“四阶梯模式”,肠外营养通路选择时应考虑照射野的影响。肿瘤放疗患者的营养方案应综合考虑:能量、糖脂供能比、蛋白质、维生素和免疫营养素。肿瘤放疗患者在“围放疗期”需要进行全程营养管理,并做好放疗营养的检测与随访。笔者认为,肿瘤放疗营养的发展应着力于基础研究、临床规范及转化研究,以助力临床放疗营养水平的提高和规范化,从而造福广大的肿瘤患者。
The incidence of malnutrition in patients with radiotherapy for tumors is high,and the core concept of radiation nutrition for tumors is to prevent,diagnose,treat,evaluate and detect malnutrition in patients with radiation for tumors,so as to reduce the toxic side effects of radiotherapy and increase the efficacy of radiotherapy.Radiotherapy is a"double-edged sword"for nutrition,with positive and negative effects.Improving malnutrition is of great significance for tumor radiation therapy,which can significantly improve the efficacy of tumor treatment and improve overall survival.Radiation nutrition requires the establishment of an multidisciplinary team,and standardized diagnosis of radiation nutrition should be combined with patient-generated subjective global assessment score and Radiation Therapy Oncology Group criteria.The selection of enteral nutrition access follows the"four-step model",and the influence of the irradiation field should be considered when selecting the parenteral nutrition pathway.Nutritional regimens for patients undergoing radiotherapy for tumors should be considered in a combination of"energy,glycolipid-to-energy ratio,protein,vitamins,and immunonutrients".Patients with radiotherapy for tumors need to manage the whole process of nutrition during the"peri-radiotherapy period",and do a good job in the detection and follow-up of radiation nutrition.The author believes that the development of tumor radiation nutrition should focus on basic research,clinical criterion and translation research,in order to help improve and standardize the level of clinical radiation nutrition,and benefit the majority of tumor patients.
作者
匡浩
李涛
Kuang Hao;Li Tao(Department of Radiotherapy,Cancer Hospital Affiliated to Medical College,University of Electronic Science and Technology of China,Chengdu 610041,Sichuan,China)
出处
《肿瘤代谢与营养电子杂志》
2023年第2期166-171,I0004,共7页
Electronic Journal of Metabolism and Nutrition of Cancer
关键词
肿瘤
放疗
肿瘤放疗营养
Tumor
Radiotherapy
Radiation nutrition
