Cachexia and sarcopenia at oncological patients: diagnostics and treatment tactics

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Abstract

Background. The features of malnutrition are revealed at 30–85% of oncological patients.

Aims. To represent present knowledges on causes and mechanisms of development, clinical features and treatment of cachexia and sarcopenia at oncological patients, including nutritional support and target pharmacotherapy.

Discussion. Cancer cachexia it is necessary to install in case of weight loss on 10% and more from initial and body mass index in adults less than 17 kg/m2. To diagnose of sarcopenia and cachexia are used the bioelectrical impedance analysis, computer and the magnetic resonances tomography. To be treated and warning of sarcopenia and cachexia is used the nutritional support. The enteral nutrition is appointed, when the energy intakes with nutrition less than 60% from required during 1–2 weeks, or in the presence of sarcopenia or cachexia. Beyond that, the oncological patients are to get the target pharmacotherapy. For maintaining of muscle mass by the oncological of a patients it is recommended physical activity, exercise, this refers and to palliative patients.

Conclusion. Cachexia and sarcopenia are characteristic of most of the oncological patients. The development of these conditions can cause substantial increase of different complicating diseases and lethality. To prevent their may be in due time designated personalized nutritional support, including additional enteral nutrition and target pharmacometabolic therapy.

About the authors

I. E. Khoroshilov

North-Western State Medical University named after I.I. Mechnikov

Author for correspondence.
Email: ighor1@yandex.ru
SPIN-code: 4517-3380

д.м.н., профессор кафедры анестезиологии и реаниматологии

Russian Federation, 41, Kirochnaya street, Saint-Petersburg, 191015

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Supplementary files

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2. Fig. 1. The relationship of muscle loss, complication rates and mortality

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3. Fig. 2. The scale of prognostic assessment of the life expectancy of cancer patients

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4. Fig. 3. Causes of cancer cachexia

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5. Fig. 4. Intracellular mechanisms of muscle protein proteolysis and catabolism

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6. Fig. 5. The stages of development of cachexia (according to Fearon K., 2011, modified. [7])

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Copyright (c) 2020 Khoroshilov I.E.

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