肿瘤恶液质的药物治疗研究进展

王超云; 杜成; 关欣; 杜晓薇; 徐竹轩; 郑振东

doi:10.16689/j.cnki.cn11-9349/r.2019.03.022

肿瘤代谢与营养电子杂志 >

2019 , Vol. 6 >Issue 3: 382 - 385

DOI: https://doi.org/10.16689/j.cnki.cn11-9349/r.2019.03.022

综述

肿瘤恶液质的药物治疗研究进展

王超云 ,
杜成 ,
关欣 ,
杜晓薇 ,
徐竹轩 ,
郑振东

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中国人民解放军北部战区总医院肿瘤科，沈阳 110840

网络出版日期: 2021-04-12

基金资助

辽宁省自然科学基金（20170540966）

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Advances in drug therapy for cancer cachexia

WANG Chao-yun ,
DU Cheng ,
GUAN Xin ,
DU Xiao-wei ,
XU Zhu-xuan ,
ZHENG Zhen-dong

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Department of Oncology General Hospital of Northern Theater Command， Shenyang 110840， Liaoning， China

Online published: 2021-04-12

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摘要

当恶性肿瘤发展到晚期的时候，肿瘤恶液质是其中较为常见的一类并发症，临床症状表现为肌肉、骨骼量减少，或存在脂肪含量降低、食欲下降、人体代谢失调，进而导致器官功能缺失。研究发现约五分之一的恶性肿瘤患者因肿瘤恶液质导致死亡，肿瘤恶液质的发生对患者生活造成严重影响，增加治疗时间、提高治疗成本、生活质量下降、减少生存时间。肿瘤恶液质发病机制较为复杂，目前已知的发病机制包括在肿瘤组织的长期刺激下引发的不可逆转性慢性炎症；炎症反应后影响人体代谢平衡；炎性因子抑制中枢神经有益物质的分泌，减少人体食欲信号等。现阶段临床上对于该疾病的发病原理取得一定研究成果，随着研究的不断深入，对其治疗药物具有一定的认识。针对其发病机制治疗肿瘤恶液质需要多种渠道共同作用，给予患者充分的营养以及药物联用等。本文将从目前使用较多的食欲刺激类药物（孕激素、胃饥饿素）、抗炎类（非甾体抗炎药、沙利度胺、ω-3脂肪酸）、蛋白降解抑制类、代谢调节类（雄激素受体调节剂、β-受体阻滞剂）药物治疗的效果展开分析，并针对目前药物联合治疗的研究进展进行讨论。

关键词： 恶性肿瘤; 肿瘤恶液质; 食欲刺激; 代谢调节

本文引用格式

王超云 , 杜成 , 关欣 , 杜晓薇 , 徐竹轩 , 郑振东 . 肿瘤恶液质的药物治疗研究进展[J]. 肿瘤代谢与营养电子杂志, 2019 , 6(3) : 382 -385 . DOI: 10.16689/j.cnki.cn11-9349/r.2019.03.022

Abstract

When malignant tumors develop to the late stage， cancer cachexia (CC) is one of the most common complications. Its clinical symptoms are generally manifested as a decrease in muscle and bone mass， or a decrease in fat content， loss of appetite， and metabolic disorders， which lead to organ dysfunction. The study found that about one fifth of malignant tumor patients died from CC. The occurrence of CC has a serious impact on patients'lives， increasing treatment time， improving treatment cost， decreasing quality of life and reducing survival time. The pathogenesis of CC is complex. The known pathogenesis includes irreversible chronic inflammation induced by long-term stimulation of tumor tissue， the influence of inflammatory reaction on human metabolic balance， the inhibition of secretion of beneficial substances in central nervous system by inflammatory factors， and the reduction of appetite signals. At the present stage， some research results have been obtained on the pathogenesis of this disease. With the deepening of the research， we have a certain understanding of its therapeutic drugs. In view of its pathogenesis， the treatment of CC requires a variety of channels to work together， to give patients adequate nutrition and drug combination. This article from the current use of more appetite-stimulating drugs (progesterone， gastrin)， anti-inflammatory drugs (non-steroidal anti-inflammatory drugs， thalidomide， omega-3 fatty acids)， protein degradation inhibitors， metabolic regulators (androgen receptor regulators， beta-receptor blockers)analyzes the effect of the medication， and on the research progress of drug combination therapy is discussed.

Key words： Malignant tumors;; Cancer cachexia; Appetite stimulation; Metabolic regulation

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