Aproximación terapéutica al síndrome de anorexia-caquexia en pacientes con cáncer. Revisión sistemática de la literatura

Abstract

Objective: To review what has been published in the scientific literature about the treatment options of the anorexia- cachexia syndrome in cancer patients. Method: We performed a systematic review of the literature. Databases used were: PubMed, Cochrane, Elsevier, Wiley y Google Scholar, with date restriction 01/01/1990-31/12/2015. Languages were English and Spanish, Key words used were: “fatigue, anorexia, cachexia, cancer in English and Spanish. In PubMed, search strategy were: “Tumoral cachexia AND treatment” and “Fatigue, anorexia, cachexia AND cancer”. Articles included had to offer information about any treatment option to the cachexia syndrome. Articles including patients suffering from other illness than cancer were excluded. Papers selection was done base on title and abstract information. In some cases the inclusion was done after reading all the content. Information selected was: type of study, inclusion criteria, simple size, type of cancer, type of treatment and results. Results: In PubMed, based on the search strategy: “tumoral cachexia AND treatment” we found 16 papers but only one was included. Based on the search strategy “fatigue, anorexia, cachexia AND cancer” we found 106 papers but only 8 clinical trials were included. Other related articles were included: 4 clinical trials and 8 narrative reviews. Conclusion: 1) The methodological differences among the papers reviewed make impossible to develop a methaanalisis. 2) Most of the treatment lines are based on metabolic modulation. 3) It is controversial the use of nutritional supplements to improve prognosis in advanced cancer patient. 4) Among cancer cachexia treatments suggested the megestrol acetate is the election option. 5) New drugs as ghrelin have shown optimistic results.