Review of ESPEN-2021 Practice Guidelines for Patients with Cancer. Part 2: Interventions Relevant to Specific Patient Categories

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Abstract

This study further discussed the 2021 ESPEN practical recommendations for nutritional support in oncology. The updated version of the 2021 ESPEN practice guidelines differs slightly from the 2017 version and contains flowcharts to facilitate the use of the guidelines in clinical practice, which is also relevant for domestic healthcare. ESPEN-2021 Clinical Guidelines, which offer practical solutions in all areas of oncology, are significant to both oncologists and allied specialists working in oncology. The second part of the review discusses particular issues of nutritional support for patients with cancer and analyzes the domestic experience of their use. The review provides the main protocols for artificial nutrition in surgery, during irradiation, and in drug therapy in patients in remission and at the palliative stage and proves the need to maintain physical activity in patients with cancer. The presented practical guidance allows organizing an adequate supply of nutrient substrates to patients with cancer receiving various types of anticancer treatment, in remission, and at the stage of palliative care.

About the authors

Anastasia S. Ivanova

Lomonosov Moscow State University

Email: i.anastasia@hotmail.com
ORCID iD: 0000-0001-7321-4323
SPIN-code: 2179-2310
Russian Federation, Moscow

Olga A. Obukhova

N.N. Blokhin National Medical Research Center of Oncology

Author for correspondence.
Email: obukhova0404@yandex.ru
ORCID iD: 0000-0003-0197-7721
SPIN-code: 6876-7701

MD, Cand. Sci. (Med.)

Russian Federation, Moscow

Ildar A. Kurmukov

N.N. Blokhin National Medical Research Center of Oncology

Email: kurmukovia@gmail.com
ORCID iD: 0000-0001-8463-2600
SPIN-code: 3692-5202

MD, Cand. Sci. (Med.)

Russian Federation, Moscow

Larisa Ya. Volf

Nutricia LLC

Email: larisa.volf@danone.com
ORCID iD: 0000-0002-6025-8420
SPIN-code: 3590-9746
Russian Federation, Moscow

References

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Supplementary files

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2. Fig. 1. Structure of the ESPEN practical guideline “Clinical nutrition in cancer”. Modified from [1].

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3. Fig. 2. General concepts of treatment relevant to all cancer patients: screening and assessment, energy and substrate requirements). Modified from [1].Note: ИМТ — body mass index; МТ — body mass; НП — nutritional support.

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4. Fig. 3. Particular issues of nutritional support: surgery. Modified from [1].Note: НН — nutritional deficiency; ЗНО — malignant neoplasms; ЖКТ — gastrointestinal tract.

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5. Fig. 4. Particular issues of nutritional support: radiation therapy. Modified from [1].Note: ЛТ — radiation therapy; ЖКТ — gastrointestinal tract; ЗНО — malignant neoplasms; ПП — parenteral nutrition; ЭП — enteral nutrition; ЧЭГ — percutaneous endoscopic gastrostomy.

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6. Fig. 5. Particular issues of nutritional support: chemotherapy. Modified from [1].Note: ХТ — chemotherapy; ПП — parenteral nutrition; ЭП — enteral nutrition; ВДХТ — high-dose chemotherapy; ТГСК — hematopoietic stem cell transplantation; ТПХ — graft versus host; НП — nutritional support; ЛФК — therapeutic physical culture.

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7. Fig. 6. Particular issues of nutritional support: patients in remission and receiving palliative care. Modified from [1].Note: ИМТ — body mass index; МТ — body weight; НН — nutritional deficiency; НП — nutritional support; ПП — parenteral nutrition.

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