肿瘤放疗与营养治疗观点:基础营养与精准营养并重

Cancer radiotherapy and nutritional therapy laying equal stress on basic nutrition and precision nutrition

营养不良是恶性肿瘤放疗患者常见合并症和并发症。营养不良会降低放疗疗效,增加放疗不良反应,甚至会缩短患者生存时间,降低生存质量,同时放疗也可能会加重营养不良。营养治疗对接受放疗的肿瘤患者至关重要,对接受放疗的肿瘤患者进行规范、有效的营养治疗具有重要意义。肿瘤营养治疗,应作为一线基础治疗,贯穿肿瘤治疗始终,恶性肿瘤患者“围放疗期”十分有必要进行全程化营养管理。肿瘤是一种代谢性疾病,基础营养治疗除了要满足肿瘤患者基本目标能量、蛋白质及营养素需求外,还应该积极探索饮食调节、靶向肿瘤代谢、免疫营养等方面的个体化精准营养治疗。肿瘤营养治疗不仅补充能量和营养素,还调节肿瘤免疫与代谢,甚至提高生存率。基础营养和精准营养疗法应该并重。同时,肿瘤患者在治疗期间会遭受各种心理和生理上的打击,多模式整合康复能协同提高患者康复水平,使临床康复一体化。在放疗患者中开展以营养治疗为基础的多模式整合康复临床应用效果也亟待大型随机对照试验等进一步验证。

Malnutrition is a common comorbidity and complication in cancer patients undergoing radiotherapy.It can reduce the efficacy of radiotherapy,increase adverse reactions to radiotherapy,and even impact the patient's survival time and quality of life.Nutritional therapy is crucial for cancer patients undergoing radiotherapy,and it is of great significance to provide standardized and effective nutritional treatment for these patients.Nutritional therapy for cancer should be considered as first line and fundamental treatment,integrated throughout the entire process of cancer treatment.It is essential for cancer patients to undergo comprehensive nutritional management throughout the"peri-radiotherapy period".Cancer is a metabolic disease,and in addition to providing basic nutritional therapy to meet the basic energy,protein,and nutrient needs of cancer patients,personalized and precise nutritional therapy should also actively explore aspects such as dietary regulation,targeting tumor metabolism,and immunonutrition.Cancer nutritional therapy is not only about supplementing energy and nutrients but also about regulating cancer metabolism and immunity,and even improving survival rates.Both basic nutrition and precise nutritional therapy should be emphasized.Furthermore,cancer patients endure various psychological and physiological impacts during their treatment.Multimodal integrated rehabilitation can synergistically enhance the patients'recovery,making clinical rehabilitation integrated.Research is urgently needed to further explore the clinical application of multimodal integrated rehabilitation based on nutritional therapy in radiotherapy patients through large-scale randomized controlled trials.