Research status and progress of nutritional support therapy for pancreatic cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

阿提古·阿布都外力 ,  XU Xinjian

Department of Pancreatic Surgery, Digestive Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, P. R. China;

Corresponding author：

XU Xinjian, Email: xxj0991@163.com

Keywords：

pancreatic cancer; nutritional support; chemotherapy; efficacy evaluation; nutritional screening

DOI：

10.7507/1007-9424.202006136

Video：

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Objective To summarize the current status and progress of nutritional support therapy for pancreatic cancer in order to improve the understanding of the impact of nutritional support treatment on pancreatic cancer and guide clinical work.Method The literatures about nutritional support and chemotherapy for pancreatic cancer at home and abroad were read and reviewed.Results For most patients with malignant pancreatic tumors, nutritional risk or malnutrition might accompany them for a lifetime. Regular nutritional risk screening, timely nutritional assessment and necessary nutritional treatment played an extremely important role in the process of comprehensive anti-tumor treatment.Conclusion Although there are still some core problems to be solved in nutritional support therapy and chemotherapy for pancreatic cancer, its efficacy is gradually recognized and widely used by clinical workers, which might be helpful to improve the prognosis of patients with pancreatic cancer.

Citation： XU Xinjian. Research status and progress of nutritional support therapy for pancreatic cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(4): 556-560. doi: 10.7507/1007-9424.202006136 Copy

1.	中国抗癌协会, 中国抗癌协会肿瘤营养与支持治疗专业委员会, 中国抗癌协会肿瘤康复与姑息治疗专业委员会, 等. 化疗患者营养治疗指南. 肿瘤代谢与营养电子杂志, 2016, 3(3): 158-162, 163.
2.	Mantzorou M, Koutelidakis A, Theocharis S, et al. Clinical value of nutritional status in cancer: what is its impact and how it affects disease progression and prognosis? Nutr Cancer, 2017, 69(8): 1151-1176.
3.	应丽美, 陈芳芳, 陈艺丹, 等. 国内肿瘤患者的营养风险及营养不良研究现状分析. 肿瘤代谢与营养电子杂志, 2017, 4(2): 226-231.
4.	Gärtner S, Krüger J, Aghdassi AA, et al. Nutrition in pancreatic cancer: a review. Gastrointest Tumors, 2016, 2(4): 195-202.
5.	Jung MK. Nutritional support for patients with pancreatic cancer. Korean J Gastroenterol, 2019, 74(2): 87-94.
6.	O’Neill L, Guinan E, Doyle S, et al. Rehabilitation strategies following oesophagogastric and hepatopancreaticobiliary cancer (ReStOre Ⅱ): a protocol for a randomized controlled trial. BMC Cancer, 2020, 20(1): 415.
7.	Teitelbaum D, Guenter P, Howell WH, et al. Definition of terms, style, and conventions used in A. S. P. E. N. guidelines and standards. Nutr Clin Pract, 2005, 20(2): 281-285.
8.	Kondrup J, Rasmussen HH, Hamberg O, et al. Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials. Clin Nutr, 2003, 22(3): 321-336.
9.	Druyan ME, Compher C, Boullata JI, et al. Clinical guidelines for the use of parenteral and enteral nutrition in adult and pediatric patients: applying the GRADE system to development of A. S. P. E. N. clinical guidelines. JPEN J Parenter Enteral Nutr, 2012, 36(1): 77-80.
10.	Arends J, Bachmann P, Baracos V, et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr, 2017, 36(1): 11-48.
11.	熊佳更, 杨佳元, 钱祝银. 《2018年国际胰腺外科研究小组立场文件: 胰腺手术的营养支持和治疗》摘译. 临床肝胆病杂志, 2018, 34(11): 2324-2328.
12.	Deftereos I, Kiss N, Isenring E, et al. A systematic review of the effect of preoperative nutrition support on nutritional status and treatment outcomes in upper gastrointestinal cancer resection. Eur J Surg Oncol, 2020, 46(8): 1423-1434.
13.	Weimann A, Braga M, Carli F, et al. ESPEN guideline: Clinical nutrition in surgery. Clin Nutr, 2017, 36(3): 623-650.
14.	Ligthart-Melis GC, Weijs PJ, te Boveldt ND, et al. Dietician-delivered intensive nutritional support is associated with a decrease in severe postoperative complications after surgery in patients with esophageal cancer. Dis Esophagus, 2013, 26(6): 587-593.
15.	Motoi F, Unno M. Adjuvant and neoadjuvant treatment for pancreatic adenocarcinoma. Jpn J Clin Oncol, 2020, 50(5): 483-489.
16.	Palmer DH, Stocken DD, Hewitt H, et al. A randomized phase 2 trial of neoadjuvant chemotherapy in resectable pancreatic cancer: gemcitabine alone versus gemcitabine combined with cisplatin. Ann Surg Oncol, 2007, 14(7): 2088-2096.
17.	Gianotti L, Besselink MG, Sandini M, et al. Nutritional support and therapy in pancreatic surgery: A position paper of the International Study Group on Pancreatic Surgery (ISGPS). Surgery, 2018, 164(5): 1035-1048.
18.	Bockhorn M, Uzunoglu FG, Adham M, et al. Borderline resectable pancreatic cancer: a consensus statement by the International Study Group of Pancreatic Surgery (ISGPS). Surgery, 2014, 155(6): 977-988.
19.	马英霞. 不同营养支持方式对胰腺癌患者胰十二指肠切除术后胃肠功能的影响. 广西医学, 2018, 40(5): 509-512.
20.	Lassen K, Coolsen MM, Slim K, et al. Guidelines for perioperative care for pancreaticoduodenectomy: Enhanced Recovery After Surgery (ERAS®) Society recommendations. World J Surg, 2013, 37(2): 240-258.
21.	Lambert A, Schwarz L, Borbath I, et al. An update on treatment options for pancreatic adenocarcinoma. Ther Adv Med Oncol, 2019, 11: 1758835919875568.
22.	Passeri M, Lyman WB, Murphy K, et al. Implementing an ERAS protocol for pancreaticoduodenectomy does not affect oncologic outcomes when compared with traditional recovery. Am Surg, 2020, 86(2): e81-e83.
23.	CSCO肿瘤营养治疗专家委员会. 恶性肿瘤患者的营养治疗专家共识. 临床肿瘤学杂志, 2012, 17(1): 59-73.
24.	Lin QJ, Yang F, Jin C, et al. Current status and progress of pancreatic cancer in China. World J Gastroenterol, 2015, 21(26): 7988-8003.
25.	Bibby N, Griffin O. Nutritional considerations for the management of the older person with hepato-pancreatico-biliary malignancy. Eur J Surg Oncol, 2021, 47(3 Pt A): 533-538.
26.	Elia M, Normand C, Laviano A, et al. A systematic review of the cost and cost effectiveness of using standard oral nutritional supplements in community and care home settings. Clin Nutr, 2016, 35(1): 125-137.
27.	Parsons EL, Stratton RJ, Cawood AL, et al. Oral nutritional supplements in a randomised trial are more effective than dietary advice at improving quality of life in malnourished care home residents. Clin Nutr, 2017, 36(1): 134-142.
28.	Singer P, Blaser AR, Berger MM, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr, 2019, 38(1): 48-79.
29.	刘燕, 杜翠萍. 肠内营养规范化管理对危重症患者的影响. 医药前沿, 2019, 9(5): 247.
30.	Feinberg J, Nielsen EE, Korang SK, et al. Nutrition support in hospitalised adults at nutritional risk. Cochrane Database Syst Rev, 2017, 5(5): CD011598.
31.	蒋朱明. 临床诊疗指南: 肠外肠内营养学分册(2008 版). 北京: 人民卫生出版社, 2009.
32.	Bozzetti F, Arends J, Lundholm K, et al. ESPEN guidelines on parenteral nutrition: non-surgical oncology. Clin Nutr, 2009, 28(4): 445-454.
33.	August DA, Huhmann MB. ASPEN clinical guidelines: nutrition support therapy during adult anticancer treatment and in hematopoietic cell transplantation. JPEN J Parenter Enteral Nutr, 2009, 33(5): 472-500.
34.	Simons S, Remington R. The percutaneous endoscopic gastrostomy tube: a nurse’s guide to PEG tubes. Medsurg Nurs, 2013, 22(2): 77-83.
35.	Han H, Pan M, Tao Y, et al. Early enteral nutrition is associated with faster post-esophagectomy recovery in Chinese esophageal cancer patients: a retrospective cohort study. Nutr Cancer, 2018, 70(2): 221-228.
36.	Cai J, Yang G, Tao Y, et al. A meta-analysis of the effect of early enteral nutrition versus total parenteral nutrition on patients after pancreaticoduodenectomy. HPB (Oxford), 2020, 22(1): 20-25.
37.	Gronnier C, Chambrier C, Duhamel A, et al. Enteral versus parenteral nutrition in the conservative treatment of upper gastrointestinal fistula after surgery: a multicenter, randomized, parallel-group, open-label, phase Ⅲ study (NUTRILEAK study). Trials, 2020, 21(1): 448.
38.	乔涌起, 葛文頔, 郑潇濠, 等. 不同营养支持方式对胃癌患者术后恢复的影响. 中华肿瘤杂志, 2019, 41(5): 378-383.

1. 中国抗癌协会, 中国抗癌协会肿瘤营养与支持治疗专业委员会, 中国抗癌协会肿瘤康复与姑息治疗专业委员会, 等. 化疗患者营养治疗指南. 肿瘤代谢与营养电子杂志, 2016, 3(3): 158-162, 163.
2. Mantzorou M, Koutelidakis A, Theocharis S, et al. Clinical value of nutritional status in cancer: what is its impact and how it affects disease progression and prognosis? Nutr Cancer, 2017, 69(8): 1151-1176.
3. 应丽美, 陈芳芳, 陈艺丹, 等. 国内肿瘤患者的营养风险及营养不良研究现状分析. 肿瘤代谢与营养电子杂志, 2017, 4(2): 226-231.
4. Gärtner S, Krüger J, Aghdassi AA, et al. Nutrition in pancreatic cancer: a review. Gastrointest Tumors, 2016, 2(4): 195-202.
5. Jung MK. Nutritional support for patients with pancreatic cancer. Korean J Gastroenterol, 2019, 74(2): 87-94.
6. O’Neill L, Guinan E, Doyle S, et al. Rehabilitation strategies following oesophagogastric and hepatopancreaticobiliary cancer (ReStOre Ⅱ): a protocol for a randomized controlled trial. BMC Cancer, 2020, 20(1): 415.
7. Teitelbaum D, Guenter P, Howell WH, et al. Definition of terms, style, and conventions used in A. S. P. E. N. guidelines and standards. Nutr Clin Pract, 2005, 20(2): 281-285.
8. Kondrup J, Rasmussen HH, Hamberg O, et al. Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials. Clin Nutr, 2003, 22(3): 321-336.
9. Druyan ME, Compher C, Boullata JI, et al. Clinical guidelines for the use of parenteral and enteral nutrition in adult and pediatric patients: applying the GRADE system to development of A. S. P. E. N. clinical guidelines. JPEN J Parenter Enteral Nutr, 2012, 36(1): 77-80.
10. Arends J, Bachmann P, Baracos V, et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr, 2017, 36(1): 11-48.
11. 熊佳更, 杨佳元, 钱祝银. 《2018年国际胰腺外科研究小组立场文件: 胰腺手术的营养支持和治疗》摘译. 临床肝胆病杂志, 2018, 34(11): 2324-2328.
12. Deftereos I, Kiss N, Isenring E, et al. A systematic review of the effect of preoperative nutrition support on nutritional status and treatment outcomes in upper gastrointestinal cancer resection. Eur J Surg Oncol, 2020, 46(8): 1423-1434.
13. Weimann A, Braga M, Carli F, et al. ESPEN guideline: Clinical nutrition in surgery. Clin Nutr, 2017, 36(3): 623-650.
14. Ligthart-Melis GC, Weijs PJ, te Boveldt ND, et al. Dietician-delivered intensive nutritional support is associated with a decrease in severe postoperative complications after surgery in patients with esophageal cancer. Dis Esophagus, 2013, 26(6): 587-593.
15. Motoi F, Unno M. Adjuvant and neoadjuvant treatment for pancreatic adenocarcinoma. Jpn J Clin Oncol, 2020, 50(5): 483-489.
16. Palmer DH, Stocken DD, Hewitt H, et al. A randomized phase 2 trial of neoadjuvant chemotherapy in resectable pancreatic cancer: gemcitabine alone versus gemcitabine combined with cisplatin. Ann Surg Oncol, 2007, 14(7): 2088-2096.
17. Gianotti L, Besselink MG, Sandini M, et al. Nutritional support and therapy in pancreatic surgery: A position paper of the International Study Group on Pancreatic Surgery (ISGPS). Surgery, 2018, 164(5): 1035-1048.
18. Bockhorn M, Uzunoglu FG, Adham M, et al. Borderline resectable pancreatic cancer: a consensus statement by the International Study Group of Pancreatic Surgery (ISGPS). Surgery, 2014, 155(6): 977-988.
19. 马英霞. 不同营养支持方式对胰腺癌患者胰十二指肠切除术后胃肠功能的影响. 广西医学, 2018, 40(5): 509-512.
20. Lassen K, Coolsen MM, Slim K, et al. Guidelines for perioperative care for pancreaticoduodenectomy: Enhanced Recovery After Surgery (ERAS®) Society recommendations. World J Surg, 2013, 37(2): 240-258.
21. Lambert A, Schwarz L, Borbath I, et al. An update on treatment options for pancreatic adenocarcinoma. Ther Adv Med Oncol, 2019, 11: 1758835919875568.
22. Passeri M, Lyman WB, Murphy K, et al. Implementing an ERAS protocol for pancreaticoduodenectomy does not affect oncologic outcomes when compared with traditional recovery. Am Surg, 2020, 86(2): e81-e83.
23. CSCO肿瘤营养治疗专家委员会. 恶性肿瘤患者的营养治疗专家共识. 临床肿瘤学杂志, 2012, 17(1): 59-73.
24. Lin QJ, Yang F, Jin C, et al. Current status and progress of pancreatic cancer in China. World J Gastroenterol, 2015, 21(26): 7988-8003.
25. Bibby N, Griffin O. Nutritional considerations for the management of the older person with hepato-pancreatico-biliary malignancy. Eur J Surg Oncol, 2021, 47(3 Pt A): 533-538.
26. Elia M, Normand C, Laviano A, et al. A systematic review of the cost and cost effectiveness of using standard oral nutritional supplements in community and care home settings. Clin Nutr, 2016, 35(1): 125-137.
27. Parsons EL, Stratton RJ, Cawood AL, et al. Oral nutritional supplements in a randomised trial are more effective than dietary advice at improving quality of life in malnourished care home residents. Clin Nutr, 2017, 36(1): 134-142.
28. Singer P, Blaser AR, Berger MM, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr, 2019, 38(1): 48-79.
29. 刘燕, 杜翠萍. 肠内营养规范化管理对危重症患者的影响. 医药前沿, 2019, 9(5): 247.
30. Feinberg J, Nielsen EE, Korang SK, et al. Nutrition support in hospitalised adults at nutritional risk. Cochrane Database Syst Rev, 2017, 5(5): CD011598.
31. 蒋朱明. 临床诊疗指南: 肠外肠内营养学分册(2008 版). 北京: 人民卫生出版社, 2009.
32. Bozzetti F, Arends J, Lundholm K, et al. ESPEN guidelines on parenteral nutrition: non-surgical oncology. Clin Nutr, 2009, 28(4): 445-454.
33. August DA, Huhmann MB. ASPEN clinical guidelines: nutrition support therapy during adult anticancer treatment and in hematopoietic cell transplantation. JPEN J Parenter Enteral Nutr, 2009, 33(5): 472-500.
34. Simons S, Remington R. The percutaneous endoscopic gastrostomy tube: a nurse’s guide to PEG tubes. Medsurg Nurs, 2013, 22(2): 77-83.
35. Han H, Pan M, Tao Y, et al. Early enteral nutrition is associated with faster post-esophagectomy recovery in Chinese esophageal cancer patients: a retrospective cohort study. Nutr Cancer, 2018, 70(2): 221-228.
36. Cai J, Yang G, Tao Y, et al. A meta-analysis of the effect of early enteral nutrition versus total parenteral nutrition on patients after pancreaticoduodenectomy. HPB (Oxford), 2020, 22(1): 20-25.
37. Gronnier C, Chambrier C, Duhamel A, et al. Enteral versus parenteral nutrition in the conservative treatment of upper gastrointestinal fistula after surgery: a multicenter, randomized, parallel-group, open-label, phase Ⅲ study (NUTRILEAK study). Trials, 2020, 21(1): 448.
38. 乔涌起, 葛文頔, 郑潇濠, 等. 不同营养支持方式对胃癌患者术后恢复的影响. 中华肿瘤杂志, 2019, 41(5): 378-383.

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