Editorial: Merging therapeutics and supportive care: synergy and yield.
Editorial: Merging therapeutics and supportive care: synergy and yield.
复制标题
社论：合并治疗和支持护理：协同作用和产量。
DOI：
10.1097/spc.0000000000000468
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发表时间：
2019
影响因子：
2.1
通讯作者：
Laird,BarryJA
中科院分区：
文献类型：
--
作者：
Jatoi,Aminah;Laird,BarryJA
Altman认为，合并会产生实质性的协同效应[1]。然而，直到最近，临床医生才从身体成分变化的情况和后果以及这种变化如何改善疾病结局的角度来研究这种支持性护理模式。在本期《支持和姑息治疗的最新观点》中，各种值得注意的文章讨论了胰腺癌患者肌肉损失的影响、胸部恶性肿瘤患者肌肉损失的影响、认识心脏恶病质和及时干预的重要性、似乎导致癌症患者肌肉损失的代谢变化，关注和警惕的不良事件时，管理化疗减肥癌症患者，评估最佳和最适当的饮食干预减肥肺癌患者，和宿主代谢和癌症免疫治疗之间的相互作用。Basile等人（第100页）279-285）指出，癌症治疗以及宿主-肿瘤相互作用和导致的炎症反应可导致肌肉萎缩。这些作者强调，用于告知化疗剂量的传统体表面积测量未考虑受其水溶性或亲脂性分散影响的治疗药代动力学。事实上，人们公认治疗癌症恶病质的最佳方法是治疗潜在的癌症;然而癌症治疗可能导致营养和肌肉缺陷。因此，最好的癌症治疗方法与恶病质的最佳治疗方法相结合是理所当然的。一个步骤的变化将需要使身体成分评估成为抗癌治疗处方的基础，并希望在未来，有效的恶病质治疗。
Altman argues that mergers generate substantial synergies [1]. However, only recently are clinicians examining this supportive care paradigm from the standpoint of the circumstances and consequences of body composition changes and how such changes might improve disease outcomes. In this issue of Current Opinion in Supportive and Palliative Care, a variety of noteworthy articles discuss such topics as the implications of muscle loss in patients with pancreas cancer, the implications of muscle loss in patients with thoracic malignancies, the importance of recognizing cardiac cachexia and of intervening in a timely manner, the panoply of metabolic changes that appear to drive muscle loss in cancer patients, concern and vigilance for adverse events when administering antineoplastic therapy to weight-losing cancer patients, an assessment of the best and most appropriate dietary interventions for weight-losing patients with lung cancer, and the interplay between host metabolism and cancer immunotherapy.All the articles in the current issue are important, particularly within the context of prior work. Basile et al.(pp. 279–285) made the point that cancer therapy, as well as the host–tumor interactions and resulting inflammatory overdrive, can cause muscle wasting. These authors highlight that the traditional body surface area measurements used to inform chemotherapy dosing do not take into account the pharmacokinetics of treatment influenced by their hydro-or lipophilic dispersal. Indeed, it is acknowledged that the optimal way to treat cancer cachexia is to treat the underlying cancer; yet cancer treatment can cause nutritional and muscular deficits. It therefore stands to reason that the best-delivered cancer therapy merges the best-delivered treatment for cachexia. A step-change will be needed to enable body composition assessment to become foundational for prescribing both anticancer therapy–and, hopefully, in the future, effective cachexia therapy.