前情提要
大綱
O. 方法
O1. 基本信息
術(shù)語與縮寫
指南的目標(biāo)（目的和健康問題）
目標(biāo)人群
參與的專業(yè)組織
患者的觀點(diǎn)
目標(biāo)使用者
利益沖突和資金投入
O2. 方法
設(shè)計(jì)
檢索
推薦意見
共識(shí)
發(fā)表前審查
更新指南
O3. 發(fā)表后影響
促進(jìn)與阻礙
應(yīng)用工具
成本
監(jiān)察和審核/質(zhì)量指標(biāo)
A. 背景
代謝
臨床影響
營養(yǎng)目的
B. 癌癥患者總論
篩查
能量及底物需求
營養(yǎng)干預(yù)
運(yùn)動(dòng)訓(xùn)練
藥理營養(yǎng)素和具有藥理作用的物質(zhì)
C. 特定患者類型相關(guān)干預(yù)
手術(shù)
放療
治愈性化療
大劑量化療和造血干細(xì)胞移植
癌癥存活者
晚期癌癥
R. 參考文獻(xiàn)
E. 證據(jù)列表
第O章：方法
O1、基本信息
0、術(shù)語和縮寫
術(shù)語
“癌癥患者”是指癌癥確診后，等待或正在進(jìn)行癌癥針對(duì)性治療、對(duì)癥治療和/或接受姑息治療的患者。
癌癥治愈患者被稱為“癌癥生存者”。
“藥理營養(yǎng)素”是指以藥理劑量供給、調(diào)節(jié)免疫和代謝功能、發(fā)揮臨床結(jié)局影響的營養(yǎng)素。
縮寫
AML：急性粒細(xì)胞性（髓細(xì)胞性）白血病
ASCO：美國臨床腫瘤學(xué)會(huì)
BCAA：支鏈氨基酸
BIA：生物阻抗分析
BMI：體重指數(shù)（體質(zhì)指數(shù)、體質(zhì)量指數(shù)、身體質(zhì)量指數(shù)）
BMT：骨髓移植
BMR：基礎(chǔ)代謝率
CHT：化療
CRP：C-反應(yīng)蛋白
d：天
DEXA：雙能X線骨密度
DHA：22:6二十二碳六烯酸
ECOG：東部腫瘤協(xié)作組
EAPC：歐洲姑息治療協(xié)會(huì)
EFSA：歐洲食品安全局
EN：腸內(nèi)營養(yǎng)
EPA：20:5二十碳五烯酸
ERAS：術(shù)后加速康復(fù)
ESMO：歐洲腫瘤內(nèi)科學(xué)會(huì)
FDA：美國食品藥品管理局
GI：腸胃
GL：指南
GPS：格拉斯哥預(yù)后評(píng)分
GvHD：移植物抗宿主病
HCT：造血干細(xì)胞移植
HMB：β羥丁酸甲酯
HTA：16:4十六碳三烯酸酸
IGF-I：胰島素樣生長因子I
ISOO：國際口腔腫瘤學(xué)會(huì)
LOS：住院長度（天）
MA：醋酸甲地孕酮
MASCC：多國癌癥支持治療協(xié)會(huì)
mGPS：修訂格拉斯哥預(yù)后評(píng)分
MNA：微型營養(yǎng)評(píng)定
MNI：國際醫(yī)學(xué)營養(yǎng)
MST：營養(yǎng)不良篩查工具
MUST：營養(yǎng)不良通用篩查工具
NSAID：非甾體抗炎藥
NSCLC：非小細(xì)胞肺癌
ONS：口服營養(yǎng)補(bǔ)充劑
N-3脂肪酸：N-3或ω-3系列多不飽和脂肪酸
PAL：體力活動(dòng)水平
PEG：經(jīng)皮內(nèi)鏡下胃造口術(shù)
PG-SGA：患者主觀整體評(píng)定
PICO：人群利益、干預(yù)、比較、結(jié)局
PN：腸外營養(yǎng)
QoL：生活質(zhì)量
RCT：隨機(jī)對(duì)照試驗(yàn)
REE：靜息能量消耗
RT：放療
SARM：選擇性雄激素反應(yīng)調(diào)節(jié)劑
SGA：主觀整體評(píng)定
TEE：總能量消耗
THC：四氫大麻酚
TNF：腫瘤壞死因子
TPN：全腸外營養(yǎng)
WHO：世界衛(wèi)生組織
Clin Nutr. 2016 Aug 6. [Epub ahead of print]
ESPEN guidelines on nutrition in cancer patients.
Jann Arends, Patrick Bachmann, Vickie Baracos, Nicole Barthelemy, Hartmut Bertz, Federico Bozzetti, Ken Fearon, Elisabeth Hütterer, Elizabeth Isenring, Stein Kaasa, Zeljko Krznaric, Barry Laird, Maria Larsson, Alessandro Laviano, Stefan Mühlebach, Maurizio Muscaritoli, Line Oldervoll, Paula Ravasco, Tora Solheim, Florian Strasser, Marian van Bokhorst- De van der Schueren, Jean-Charles Preiser.
University of Freiburg, Germany; Centre Régional de Lutte Contre le Cancer Léon Bérard, Lyon, France; University of Alberta, Edmonton, Canada; Centre hospitalier universitaire, Liége, Belgium; University of Milan, Milan, Italy; Western General Hospital, Edinburgh, United Kingdom; Medical University of Vienna, Austria; Bond University, Gold Coast, Australia; Norwegian University of Science and Technology, Trondheim, Norway; University Hospital Center and School of Medicine, Zagreb, Croatia; Beatson West of Scotland Cancer Centre, Edinburgh, United Kingdom; Karlstad University, Karlstad, Sweden; University of Rome La Sapienza, Roma, Italy; University of Basel, Basel, Switzerland; The Norwegian Heart and Lung Association (LHL), Oslo, Norway; Faculty of Medicine, University of Lisbon, Lisbon, Portugal; European Palliative Care Research Centre (PRC), Norwegian University of Science and Technology and Cancer Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; Cantonal Hospital St. Gallen, Switzerland; VU University Medical Center (VUmc), Amsterdam, Netherlands; HAN University of Applied Sciences, Nijmegen, Netherlands; Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium.
Outline
O. METHODS
O1. Basic information
Terms and abbreviations
Goals (Objectives and health questions) of the guideline
Target Population
Professional groups involved
Patient views
Target users
Conflict of interest and funding
O2. Methods
Design
Searches
Recommendations
Consensus
Review before publication
Updating guideline
O3. Post-publication impact
Facilitators and barriers
Tools for application
Costs
Monitoring and auditing / Quality indicators
A. BACKGROUND
Metabolism
Clinical effects
Aims of nutrition
B. GENERAL CONCEPTS FOR ALL CANCER PATIENTS
Screening
Energy and substrate requirements
Nutritional interventions
Exercise training
Pharmaconutrients and pharmacological agents
C. INTERVENTIONS RELEVANT TO SPECIFIC PATIENT CATEGORIES
Surgery
Radiotherapy
Curative chemotherapy
High-dose chemotherapy and hematopoietic stem cell transplantation
Cancer survivors
Advanced cancer
R. References
E. Evidence Tables
CHAPTER O: METHODS
O1. BASIC INFORMATION
0. TERMS and ABBREVIATIONS
A "cancer patient" is a patient with a cancer diagnosis who is either waiting for or on cancer directed treatment, on symptomatic treatment, and/or receiving palliative care.
Patients cured from their cancer are termed "cancer survivors".
"Pharmaconutrients" are nutrients supplied in pharmacological doses to modulate immune and metabolic functions and exert effects on clinical outcome.
Abbreviations used
AML: acute myeloic leukemia
ASCO: American Society of Clinical Oncology
BCAA: branched-chain amino acids
BIA: bio impedance analysis
BMI: body mass index
BMT: bone marrow transplantation
BMR: basal metabolic rate
CHT: chemotherapy
CRP: C-reactive protein
d: day
DEXA: dual-energy x-ray absorptiometry
DHA: 22:6 docosahexaenoic acid
ECOG: Eastern Cooperative Oncology Group
EAPC: European Association for Palliative Care
EFSA: European Food Safety Authority
EN: enteral nutrition
EPA: 20:5 eicosapentaenoic acid
ERAS: enhanced recovery after surgery
ESMO: European Society for Medical Oncology
FDA: U.S. Food and Drug Agency
GI: gastrointestinal
GL: guideline
GPS: Glasgow Prognostic Score
GvHD: graft versus host disease
HCT: hematopoietic stem cell transplantation
HMB: ?-hydroxy methyl butyrate
HTA: 16:4 hexadecatetraenoic acid
IGF-I: insulin-like growth factor I
ISOO: International Society of Oral Oncology
LOS: length of hospital stay (days)
MA: megestrol acetate
MASCC: Multinational Association of Supportive Care in Cancer
mGPS: modified Glasgow Prognostic Score
MNA: Mini Nutritional Assessment
MNI: Medical Nutrition International
MST: Malnutrition Screening Tool
MUST: Malnutrition Universal Screening Tool
NSAID: non-steroidal anti-inflammatory drugs
NSCLC: non-small cell lung cancer
ONS: oral nutritional supplements
N-3 fatty acids: polyunsaturated fatty acids of the N-3 or omega-3 series
PAL: physical activity level
PEG: percutaneous endoscopic gastrostomy
PG-SGA: patient-generated Subjective Global Assessment
PICO: populations of interest, interventions, comparisons, outcomes
PN: parenteral nutrition
QoL: quality of life
RCT: randomized controlled trial
REE: resting energy expenditure
RT: radiotherapy
SARM: selective androgen response modifyer
SGA: Subjective Global Assessment
TEE: total energy expenditure
THC: tetrahydrocannabinol
TNF: tumor necrosis factor
TPN: total parenteral nutrition
WHO: World Health Organization
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