肿瘤免疫营养治疗指南

Guideline on cancer immunonutrition

免疫营养是一种对肿瘤发生发展过程中的免疫、代谢和炎症变化具有重要调节作用的靶向性营养治疗,是肿瘤营养治疗的重要分支,已在手术、放化疗及肿瘤并发症治疗等多个领域得到广泛应用。然而,虽然已有多项国际营养指南述及免疫营养素在肿瘤临床治疗中的应用,但多数仅作为指南中零散的部分,缺乏系统的整理和归纳,并且部分指南中相关内容及临床研究结果尚存在争议。此外,现阶段人们对肿瘤免疫营养素的具体作用机制和疗效等方面认识的不足,进一步导致了免疫营养在临床实践中应用的局限性和不规范性。因此,为了更好地指导临床实践,在循证医学的指引下,通过对近年来发表的重要临床研究结果和权威指南的收集和整理,中国抗癌协会肿瘤营养专业委员会专家对各种研究证据进行了系统分析和反复校对,并根据牛津循证医学中心意见分级标准的证据和推荐水平提出了严格的推荐意见,对《肿瘤免疫营养治疗指南》(2016年)予以更新,以期为临床肿瘤患者规范化的免疫营养治疗提供参考和依据。

Immunonutrition is a kind of targeted nutrition therapy that plays a significant role in the regulation of immune,metabolic and inflammatory changes during tumor development.It is an important branch of cancer nutrition therapy and has been widely used in many fields,such as surgery,radiotherapy and chemotherapy,and the treatment of cancer complications.However,although several international nutrition guidelines have addressed the use of immunonutrients in the clinical treatment of cancers,most of which are only scattered parts of the guidelines and lack of systematic collation and induction,and several relevant contents in the guidelines and clinical research results are still controversial.In addition,the deficient understanding of the specific mechanism and curative effect of tumor immune nutrients currently has further led to the limitation and non-standardization of immunonutrition in clinical practice.Therefore,in order to better guide clinical practice,through the collection and collation of critical clinical research results and authoritative guidelines published in recent years under the guidance of evidence-based medicine,experts of the Cancer Nutrition Committee of Chinese Anti Cancer Association have systematically analyzed and repeatedly proofread diverse research evidence,and put forward strict recommendations according to the evidence and recommendation levels in the rating criteria of Oxford Centre for Evidence-based Medicine,with a view to update the 2016 cancer immunonutrition guideline and provide a reference and basis for future standardized immunonutrition therapy for clinical cancer patients.