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DOI: 10.1055/s-2003-40045
Das Anorexie-Kachexie-Syndrom beim Bronchialkarzinom: Pathophysiologie-Therapieansätze
The Anorexia-Cachexia Syndrome in Bronchial Carcinoma - Pathophysiology Therapeutic ApproachesPublication History
Eingereicht: 13. Januar 2003
Angenommen: 13. Februar 2003
Publication Date:
18 June 2003 (online)

Einleitung
Das Anorexie-Kachexie-Syndrom stellt im Wesentlichen ein Ungleichgewicht dar zwischen Nahrungsaufnahme und Energieverbrauch und wird bei vielen akuten und chronisch-entzündlichen Prozessen [1], beim Acquired Immunodeficiency-Syndrom [2], der schweren COPD [3], kardiovaskulären Erkrankungen [4] und insbesondere bei malignen Tumoren beobachtet [5] [6].
Das Anorexie-Kachexie-Syndrom stellt in der Onkologie das am häufigsten zu beobachtende paraneoplastische Phänomen dar. 50 - 80 % aller bösartigen Tumoren gehen im fortgeschrittenen Stadium mit einem erheblichen Gewichtsverlust einher [7]. Insbesondere die Tumoren des Gastrointestinaltraktes, wie Magen-, Pankreas- und Kolonkarzinome, aber auch nichtkleinzellige und kleinzellige Bronchialkarzinome sowie Prostatakarzinome führen häufig zu einem deutlichen Gewichtsverlust, während Mammakarzinome, maligne Non-Hodgkin-Lymphome, Leukämien und Sarkome seltener zu einer Gewichtsreduktion führen [8]. Analog zeigen zum Zeitpunkt der Diagnosestellung mehr als 60 % aller Patienten mit einem Bronchialkarzinom einen Gewichtsverlust und 15 % haben mehr als 10 % ihres ursprünglichen Körpergewichtes verloren [9]. Beträgt der Gewichtsverlust über einen Zeitraum von 6 Monaten mehr als 10 % des Ausgangskörpergewichtes, kann definitionsgemäß von einem Anorexie-Kachexie-Syndrom gesprochen werden. Diese Paraneoplasie geht mit einer schlechten Prognose einher, mindert die Lebensqualität, kann zu einer erhöhten Toxizitätsrate unter Chemotherapie führen sowie in erheblichem Maße die Mortalitäts- und perioperative Morbiditätsrate erhöhen [10]. Insbesondere Kinder und ältere Erwachsene entwickeln dieses Syndrom, das durch ein komplexes Zusammenspiel von metabolischen Störungen und Verhaltensstörungen gekennzeichnet ist und mit einem Verlust an Fett- und Muskelmasse einhergeht [1].
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Marlene Heckmayr
Pneumologisch-Onkologische Abteilung, Krankenhaus Großhansdorf · Zentrum für Pneumologie und Thoraxchirurgie
22927 Großhansdorf