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La nutrizione in Oncologia Paolo Marchetti & Federica Mazzuca
La nutrizione in Oncologia
Paolo Marchetti & Federica Mazzuca
Good Nutrition Critical to Chemotherapy
• Weight loss has been shown to be a poor prognostic sign in cancer.
• Malnutrition can impair the response to treatment, quality of life, and the immune system.
• It has been estimated that 80% of cancer patients never receive a nutritional evaluation.
2
Milayna Subar, Physician's Weekly, 2011
Is there any evidence that malnutrition has a real impact on cancer treatment or on a person's chances of surviving the disease?
• Numerous studies strongly suggest that substantial malnutrition has serious consequences for cancer patients.
• Malnutrition reduces the effectiveness of chemotherapy, lowers overall quality of life and lowers patients' chances of survival.
3
J Mason, 2002
Is there any evidence that malnutrition has a real impact on cancer treatment or on a person's chances of surviving the disease?
• Aggressive nutritional support can help malnourished patients going into surgery as well as malnourished patients undergoing medical treatment (chemotherapy or targeted therapy) or radiation therapy.
4
J Mason, 2002
Elderly Cancer Patients More Likely to Be Malnourished
• Cancer patients age 65 and older are more likely than younger cancer patients to suffer from malnutrition.
• The older group was more likely to eat less food than usual (55% vs. 45%), to have a global fat deficit (56% vs. 44%) and to have existing edema (58% vs. 42%).
5
Pilar Matia, American Society for Parenteral and Enteral Nutrition, 2012
The Integration of Palliative Care into Standard Oncology Care
•How accurate is the nutritional support in oncology?
•Unfortunately, very poor!
6
Intersocietary SINPE-AIOM Project (SINPE, Italian Society for Artificial Nutrition and Metabolism
Member of the Federation of Italian Nutrition Societies; AIOM, Italian Association of Medical Oncology)
Multicenter Project on the Prevalence of Malnutrition in Oncology
ClinicalTrials.gov: NCT01622036
Patients’ characteristics according to M0-M1 staging
43,2 48,0
8,9
0,0
10,0
20,0
30,0
40,0
50,0
M0 M1 N/A
Tumor stage at diagnosis
% o
f patients
(n=
1952)
Weight loss at diagnosis (n=1947)
35,7
64,3
0
10
20
30
40
50
60
70
No loss Weight loss
Weight loss during the previous 6 months
% o
f p
atie
nts
Weight loss at diagnosis (n=1947) according to M0-M1 staging
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
M0 M1 N/A
46,6
23,8
45,1
53,4
76,2
54,9
Weight loss
No loss
% o
f p
atie
nts
3,5
13,6
6,9
36,6
48,8
33,5
59,9
37,6
59,5
0,0
10,0
20,0
30,0
40,0
50,0
60,0
70,0
80,0
M0 M1 N/A
<17
17-23,5
24-30
MNA by tumor stage (n=1925) according to M0-M1 staging
% o
f p
atie
nts
La nutrizione in oncologia
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Le Linee di Indirizzo sui percorsi nutrizionali nei pazienti oncologici, approvate in Conferenza Stato-Regioni il 14 dicembre 2017
Nutrizione in oncologia tra false credenze e acquisizioni scientifiche
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