Kachexie

Kommt es im Zuge einer chronischen Erkrankung oder eines Krebsleidens zu einem krankheitsbedingten Entzündungsprozess, resultiert häufig eine Kachexie. Sie ist geprägt von Appetitlosigkeit, Gewichtsverlust und Abnahme der Skelettmuskelmasse, schränkt die Lebensqualität der Betroffenen erheblich ein und erhöht die Mortalität. Die Therapie sollte interdisziplinär erfolgen und eine professionelle Ernährungstherapie einschließen.

Publication History

Article published online:
16 March 2023

• Literatur

• 1 Evans WJ, Morley JE, Argiles J. et al. Cachexia: a new definition. Clin Nutr 2008; 27: 793-799
• 2 Roeland EJ, Bohlke K, Baracos VE. et al. Management of Cancer Cachexia: ASCO Guideline. J Clin Oncol 2020; 38: 2438-2453
• 3 Muscaritoli M, Anker SD, Argiles J. et al. Consensus definition of sarcopenia, cachexia and pre-cachexia: joint document elaborated by Special Interest Groups (SIG) „cachexia-anorexia in chronic wasting diseases“ and „nutrition in geriatrics“. Clin Nutr 2010; 29: 154-159
• 4 Fearon K, Strasser F, Anker SD. et al. Definition and classification of cancer cachexia: an international consensus. Lancet Oncol 2011; 12: 489-495
• 5 Valentini L, Volkert D, Schütz T. et al. Leitlinie der Deutschen Gesellschaft für Ernährungsmedizin (DGEM), DGEM-Terminologie in der Klinischen Ernährung. Aktuel Ernahrungsmed 2013; 38: 97-111
• 6 McDonald MN, Wouters EFM, Rutten E. et al. It’s more than low BMI: prevalence of cachexia and associated mortality in COPD. Respir Res 2019; 20: 100
• 7 Detsky AS, McLaughlin JR, Baker JP. et al. What is subjective global assessment of nutritional status?. J Parenter Enteral Nutr 1987; 11: 8-13
• 8 Kelly TL, Berger N, Richardson TL. DXA body composition: theory and practice. Appl Radiat Isot 1998; 49: 511-513
• 9 Dabiri S, Popuri K, Cespedes Feliciano EM. et al. Muscle segmentation in axial computed tomography (CT) images at the lumbar (L3) and thoracic (T4) levels for body composition analysis. Comput Med Imaging Graph 2019; 75: 47-55
• 10 Loprinzi CL, Jatoi A. Management of cancer anorexia/cachexia. Im Internet: https://www.uptodate.com/contents/management-of-cancer-anorexia-cachexia. Stand: 22.12.2022
• 11 Advani SM, Advani PG, VonVille HM, Jafri SH. Pharmacological management of cachexia in adult cancer patients: a systematic review of clinical trials. BMC Cancer 2018; 18: 1174
• 12 Yavuzsen T, Davis MP, Walsh D. et al. Systematic review of the treatment of cancer-associated anorexia and weight loss. J Clin Oncol 2005; 23: 8500-8511
• 13 Simon L, Baldwin C, Kalea AZ, Slee A. Cannabinoid interventions for improving cachexia outcomes in cancer: a systematic review and meta-analysis. J Cachexia Sarcopenia Muscle 2022; 13: 23-41
• 14 Wright TJ, Dillon EL, Durham WJ. et al. A randomized trial of adjunct testosterone for cancer-related muscle loss in men and women. J Cachexia Sarcopenia Muscle 2018; 9: 482-496
• 15 Dobs AS, Boccia RV, Croot CC. et al. Effects of enobosarm on muscle wasting and physical function in patients with cancer: a double-blind, randomised controlled phase 2 trial. Lancet Oncol 2013; 14: 335-345
• 16 Currow D, Temel JS, Abernethy A. et al. ROMANA 3: a phase 3 safety extension study of anamorelin in advanced non-small-cell lung cancer (NSCLC) patients with cachexia. Ann Oncol 2017; 28: 1949-1956
• 17 Lundholm K, Körner U, Gunnebo L. et al. Insulin treatment in cancer cachexia: effects on survival, metabolism, and physical functioning. Clin Cancer Res 2007; 13: 2699-2706
• 18 Schuetz P, Fehr R, Baechli V. et al. Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial. Lancet 2019; 393: 2312-2321
• 19 de van der Schueren MAE, Laviano A, Blanchard H. et al. Systematic review and meta-analysis of the evidence for oral nutritional intervention on nutritional and clinical outcomes during chemo(radio)therapy: Current evidence and guidance for design of future trials. Ann Oncol 2018; 29: 1141-1153
• 20 Arends J, Bachmann P, Baracos VE. et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr 2017; 36: 11-48