2008, Number 5
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Gac Med Mex 2008; 144 (5)
Síndrome de anorexia-caquexia en el paciente oncológico.
Sosa-Sánchez R, Sánchez-Lara K, Motola-Kuba D, Green-Renner D
Language: Spanish
References: 75
Page: 435-440
PDF size: 58.62 Kb.
ABSTRACT
Approximately two thirds of cancer patients at advanced stages of the disease suffer from anorexia, which leads to significant weight loss and progressive cachexia, an important factor that contributes to death. It has been observed that cancer cachexia differs from simple starvation, although the exact mechanisms associated with cancer cachexia are not well known. Several theories regarding its pathogenesis point to a complex mixture of tumor, host and treatment variables. Unfortunately, the wasting syndrome also constitutes for the patient, a progression of the cancer process, significantly affecting quality of life and social interactions. Treatable causes should be identified and treated. Knowledge of the mechanisms underlying the effects of caquexia on the patient may play a role in identifying treatment measures targetted to muscle wasting and to maintain body strength. In this article we review the main features and mechanisms of the anorexia-cachexia syndrome in patients with cancer.
REFERENCES
Neary NM, Small CJ, Wren AM, Lee JL, Bruce MR, Palmieri C, et al. Ghrelin increases energy intake in cancer patients compared with impaired appetite: Acute, randomized, placebo-controlled trial. J Clin Endocrinol Metab 2004;89: 2832-2836.
Langstein HN, Norton JA. Mechanisms of cancer cachexia. Hematol Oncol Clin North Am 1991;5:103-123.
Huhmann MB, Cunningham RS. Importance of nutritional screening in treatment of cancer-related weight loss. Lancet Oncol 2005;6:334-343.
Tisdale MJ. Cachexia in cancer patients. Nat Rev Cancer 2002;2:862-871.
Fearon KC, Voss AC, Hustead D. Definition of cancer cachexia: Effect of weight loss, reduced food intake, and systemic inflammation on functional status and prognosis. Am J Clin Nutr 2006;83:1345-1350.
Mellar PD, Dreicer R, Walsh D, Lagman R, LeGrand SB. Appetite and cancer-associated anorexia: A review. J Clin Oncol 2004;22:1510-1517.
Bossola M, Pacelli F, Doglietto GB. Novel treatments for cancer cachexia. Expert Opin Invest Drugs 2007;16:1241-1253.
Gordon JN, Green SR, Goggin PM. Cancer cachexia. Q J Med 2005;98:779-788.
Von Roenn JH, Knopf K. Anorexia/caquexia in patients with HIV: Lessons for the oncologist. Oncology 1996;10:1049-1056.
Costa G, Bewley P, Aragon M, Sioebold J. Anorexia and weight loss in cancer patients. Cancer Treat Res 1981;65:3-7.
Lindsey AM, Piper BF, Stotts NA. The phenomenon of cancer cachexia: A review. Oncol Nurs Forum 1982;9(2):38-42.
Ferriols F, Tordera M. El síndrome caquéctico en el paciente oncológico: Fisiopatología, manifestaciones clínicas y tratamiento farmacológico. Farm Hosp 2003;37:308-316.
Palesty JA, Dudrick SJ. What we have learned about cachexia in gastrointestinal cancer. Dig Dis 2003;21:198-213.
Murry DJ, Riva L, Poplack DG. Impact of nutrition on pharmacokinetics of anti-neoplastic agents. Int J Cancer 1998;11:S48-S51.
Bossola M, Pacelli F, Tortorelli A, Doglietto GB. Cancer cachexia: It’s time for more clinical trials. Ann Surg Oncol 2007;14:276-285.
Mantovani G, Macció A, Madeddu C, Gramignano G, Lusso MR, Serpe R, et al. A phase II study with antioxidants, both in the diet and supplemented, pharmaconutritional support, progestagen, and anti-cyclooxygenase-2 showing efficacy and safety in patients with cancer-related anorexia/cachexia and oxidative stress. Cancer Epidemiol Biomark Prev 2006;15:1030-1034.
Perboni S, Inui A. Anorexia in cancer: Role of feeding-regulatory peptides. Phil Trans R Soc B 2006;361:1281-1289.
Nelson KA, Walsh D, Sheehan FA. The cancer anorexia-cachexia syndrome. J Clin Oncol 1994;12:213-225.
Heber D, Tchekmedyian NS. Mechanisms of cancer cachexia. Contemp Oncol 1995;3:6-10.
Norton JA, Brown M, King P, Collin SP, Tisdale MJ, Williams G. Hole body protein synthesis and turnover in normal man and malnourished patients with and without known cancer. Ann Surg 1991;194:123-128.
Bing C, Stein TP, Brennan MF. Increased gene expresion of brown fat uncoupling protein (UCP)1 and skeletal muscle UCP2 and UCP3 in MAC16- induced cancer cachexia. Cancer Res 2000;60:2405-2410.
Mantovani G, Madeddu C, Macció A, Gramingnano G, Lusso MR, Massa E, et al. Cancer-related anorexia/cachexia syndrome and oxidative stress: An innovative approach beyond current treatment. Cancer Epidemiol Biomark Prev 2004;13:1651-1659.
Inui A. Cancer anorexia-cachexia syndrome: Current issues in research and management. CA Cancer J Clin 2002;52:72-91.
Argiles JM, Meijsing SH, Pallares-Trujuillo, Guirao X, López-Soriano FJ. Cancer cachexia: A therapeutic approach. Med Res Rev 2001;21:83-101.
Argilés JM, López-Soriano FJ, Busquets S. Emerging drugs for cancer cachexia. Expert Opin Emerg Drugs 2007;12:555-570.
Langstein HN, Norton JA. Mechanisms of cancer cachexia. Hematol Oncol Clin North Am 1999:15:103-23.
Chance WT, Balasubramaniam A, Fischer JR. Neuropeptide Y and development of cancer cachexia. Ann Surg 1995;221:579-580.
Makarenko IG, Meguid MM, Gatto L, Chen C, Ugrumov MV. Decreased NPY innervation of the hypothalamic nuclei in rats with cancer anorexia. Brain Res 2003;96:100-108.
Wisse B, Frayo RS, Schwartz MW. Reversal of cancer anorexia by blockade of central melanocortin receptors in rats. Endocrinology 2001;142:3293-3301.
Gillard ER, Dang DQ, Stanley BG. Evidence that neuropeptide Y and dopamine in the perifornical hypothalamus interact antagonistically in the control of food intake. Brain Res 1993:628:128-136.
Flier JS. Maratos-Flier E. Obesity and the hypothalamus: Novel peptides for new pathways. Cell 1998;92:437-440.
Killgore WD, Yurgelun-Todd DA. Developmental changes in the functional brain responses of adolescents to images of high and low-calorie foods. Dev Psychobiol 2005;47:377-397.
Laviano A, Meguid MM, Rossi-Fanelli F. Cancer anorexia: Clinical implications, pathogenesis, and therapeutic strategies. Lancet Oncol 2003;4:686- 694.
Hanada T, Toshinai K, Kajimura N, Nara-Ashizawa N, Tsukada T, Hayashi Y, et al. Anti-cachectic effect of ghrelin in nude mice bearing human melanoma cells. Biochem Biophys Res Com 2003;301:275-279.
Woods SC, Schwartz MW, Baskin DG, Seeley RJ. Food intake and regulation of body weight. Annu Rev Psychol 2000;51:255-277.
Kristensen P, Judge ME, Thim L, Ribel U, Christjansen KN, Wulff BS, et al. Hypothalamic CART is a new anorectic peptide regulated by leptin. Nature 1998;393:72-76.
Laviano A, Gleason JR, Meguid M, Yang Z, Cangiano C, Rossi-Fanelli F. Effects of intra-VMN mianserin and IL-1ra on meal number in anorectic tumorbearing rats. J Invest Med 2000;48:40-48.
Laviano A, Russo M, Freda F, Rossi-Fanelli F. Neurochemical mechanisms for cancer anorexia. Nutrition 2002;8:100-105.
Fekete C, Sarkar S, Rand WM, Harney JW, Emerson CH, Bianco AC, et al. Agouti-related protein (AGRP) has a central inhibitory action on the hypothalamic- pituitary-thyroid (HPT) axis; comparisons between the effect of AGRP and neuropeptide Y on energy homeostasis and the HPT axis. Endocrinology 2002;143:3846-3853.
Inui A. Cancer anorexia-cachexia syndrome: Are neuropeptides the key? Cancer Res 1999;59:4493-4501.
Janik JE, Curti BD, Considine RV, Rager HC, Powers GC, Alvard WG et al. Interleukin 1 alpha increases serum leptin concentrations in humans. J Clin Endocrinol Metab 1997;82:3084-3086.
Mantovani G, Maccio A, Mura L, Massa E, Mudu MC, Mulas C, et al. Serum levels of leptin and proinflammatory cytokines in patients with advances-stage cancer at different sites. J Mol Med 2000;78:554-561.
Morley JE, Thomas D, Wilson MM. Cachexia-physiopathology and clinical relevance. Am J Clin Nutr 2006;83:735-743.
King PJ, Widdowson PS, Doods H, William G. Effect of cytokines on hypothalamic neuroeptide Y release in vitro. Peptides 2000;21:143-146.
Mantovani G, Macció A, Lñai P, Massa E, Ghiani M, Santona MC. Cytokine activity in cancer related anorexia/caquexia: role of megestrol acetate and medroxyprogesterone acetate. Sem Oncol 1998;25:45-53.
Langhans W, Hrupka B. Interleukins and tumor necrosis factor as inhibitors of food intake. Neuropeptides 1999;33:415-424.
Laviano A, Seguid MM, Inri A, Muscaritoli M, Rossi-Fanelli F. Therapy insight: Cancer anorexia-cachexia syndrome- When all you can eat is yourself. Nat Clin Pract Oncol 2005;2:158-165.
Karydis I, Tolis G. Orexis, anorexia and thyrotropin releasing hormone. Thyroid 1998;8:947-950.
Laviano A, Russo M, Freda F, Rossi-Fanelli F. Neurochemical mechanisms for cancer anorexia. Nutrition 2002;18:100-105.
Cardona D. Tratamiento farmacológico de la anorexia-caquexia cancerosa. Nutr Hosp 2006;21:17-26.
Jatoi A, Kumar S, Sloan J, Nguyen P. On appetite and its loss. J Clin Oncol 2000;18:2930-2932.
Macallan D. Wasting in HIV infection and AIDS. J Nutrition 1999;129:238S-42S.
Puccio M, Nathanson L. The cancer cachexia syndrome. Sem Oncol 1997;24: 277-287.
Chamberlain JS. Cachexia in cancer-zeroing in on myosin. N Engl J Med 2004; 351:2124-2125.
Maltoni M, Nanni O, Scarpi E, Rossi D, Serra P, Amadori D. High dose progestins for treatment of the cancer anorexia-cachexia syndrome. A systematic review of randomized and clinical trials. Ann Oncol 2001;12:289-300.
Vadell C, Segui MA, Jiménez-Arnau JM, Morales, S, Cirera L, Bestit I, et al. Anticachectic efficacy of megestrol acetate at different doses and versus placebo in patients with neoplastic cachexia. Am J Clin Oncol 1998;21:347-351.
Berenstein EG, Ortiz Z. Megestrol acetate for the treatment of anorexiacachexia syndrome. Cochrane Database Sist Rev 2005; 2:CD004310.
Femia RA, Gollete RE. The science of megestrol acetate delivery: Potential to improve outcomes in cachexia. Bio Drugs 2005;19:179-187.
McCarthy WD, Crowder RE, Deyden S, William S. Megestrol acetate stimulates food and water intake in the rat: Effects on regional hypothalamic neuropeptide Y concentrations. Eur J Pharmacol 1994;265:99-102.
Mantovani G, Macció A, Massa E, Madeddu C. Managing cancer-related anorexia/cachexia. Drugs 2001;61:499-514.
Kardinal CG, Loprinzi CL, Schaid DJ, Hass AC, Dose AM, Athman LM. A controlled trial of cyproheptadine in cancer patients with anorexia and/or cachexia. Cancer 1990;65:2557-2562.
Wilson J, Plourde JY, Marshall D, et al. Long-term safety and clinical effectiveness of controlled release metoclopramide in cancer-associated dispepsia syndrome: A multicentre evaluation. J Palliat Care 2002;18:84-91.
Gordon JN, Trebble TM, Ellis RD, Duncan HD, Johns T, Goggin PM. Thalidomide in the treatment of cancer cachexia: A randomised placebo controlled trial. Gut 2005;54:540-545.
Santiago A, Fajardo A. Tratamiento farmacológico de la caquexia-anorexia relacionada con el cáncer. Med Int Mex 2002;18:85-92.
Wigmore SJ, Falconer JS; Plester CE y cols. Ibuprofen reduces energy expediture and acute-phase protein production compared with placebo in pancreatic cancer patients. Br J Cancer 1995;72:185-188.
Tisdale MJ. Inhibition of lipolysis and muscle degradation by EPA in cancer cachexia. Nutrition 1996;12:S31-S33.
Meydani SN. Effect of (n-3) polyunsaturated fatty acids on cytokine production and their biologic funtion. Nutrition 1996;12:8-14.
Loprinzi CL, Kuross SA, O’Fallon JR, Gesme DH, Gerstner JB, Rospond RM et al. Randomized, placebo-controlled evaluation on hydrazaine sulfate in patients with advanced colorectal cancer. J Clin Oncol 1994;12:1121-1125.
Carbo N, López-Soriano J, Tarrago T, González O, Llovera N, López- Soriano FJ, et al. Comparative effects of beta2-adrenergic agonists on muscle waste associated with tumor growth. Cancer Lett 1997;115:113- 118.
Nelson K, Walsh D, Deeter P, Sheehan F. A phase II study of delta 9 tetrahydrocannabinol for appetite stimulation in cancer associated anorexia. J Palliat Care 1994:10:14-18.
Jatoi A, Windschitl HE, Loprinzi CL, Sloan JA, Dakhill SR, Mailliard JA, et al. Dronabidol versus megestrol acetate versus combination therapy for cancer-associated anorexia: A North Central Cancer Treatment Group Study. J Clin Oncol 2002;20:567-573.
Porter AC, Felder CC. The endocannabinoid nervous system: Unique opportunities for therapeutic intervention. Pharmacol Ther 2001;90:45-60.
Nelson KA. The cancer anorexia-cachexia syndrome. Semin Oncol 2000;27:64- 68.
Donelly S, Walsh D. The symptoms of advanced cancer. Semin Oncol 1994; 22:67-72.
Gillard ER, Dang DQ, Stanley BG. Evidence that neuropeptide Y and dopamine in the perifornical hypothalamus interact antagonistically in the control of food intake. Brain Res 1993:628:128-136.