Repercusión de la radioterapia sobre la situación nutricional del paciente oncogeriátrico. ¿Puede el oncólogo radioterápico minimizar el impacto de la radioterapia sobre el estado nutricional del enfermo mayor? / Nutritional impact of radiotherapy in oncogeriatric patients. Can radiation oncologists minimize the radiotherapy impact on the nutritional status of the elderly patient?

El cáncer en pacientes ancianos representa un reto de salud a escala mundial debido al aumento de su incidencia y su mortalidad asociada. En nuestro país es la segunda causa de muerte en mayores de 65 años. En años venideros el problema irá en aumento, con un pronóstico de personas mayores de 65 años del 35% en el año 2050. La radioterapia supone una parte fundamental del tratamiento multidisciplinar del cáncer en los pacientes ancianos, donde unas veces se plantea como primera opción terapéutica y otras, como alternativa a la cirugía y/o la quimioterapia si estas plantean demasiado riesgo. El desarrollo tecnológico de la Oncología Radioterápica en los últimos años ha permitido optimizar los tratamientos y disminuir las toxicidades en los pacientes de edad avanzada, que suelen presentar mayor incidencia de comorbilidades. Es fundamental que los profesionales implicados en el tratamiento multidisciplinar del cáncer conozcan la posible toxicidad y su manejo en los pacientes oncogeriátricos, ya que, de lo contrario, disminuyen las probabilidades de que pacientes con indicación adecuada de este tratamiento lo reciban. En este sentido, es imprescindible el reconocimiento de aquellos pacientes que puedan sufrir desnutrición o estén en riesgo de sufrirla, para iniciar una intervención nutricional que minimice una pérdida de peso que altere o incluso haga suspender el tratamiento planificado

Cancer in elderly patients represents a global health challenge due to the increase in its incidence and its associated mortality. In our country it is the second leading cause of death in people over 65 years. In the coming years, the problem will increase, with a prognosis of people over 65 years of 35% in 2050. Radiotherapy is an essential part of the multidisciplinary treatment of cancer in elderly patients, where sometimes it is considered as the first therapeutic option and others, as an alternative to surgery and/or chemotherapy if they pose too much risk. The technological development of Radiation Oncology in recent years has allowed optimizing treatments and reducing side effects in elderly patients, who tend to have a higher incidence of comorbidities. It is essential that professionals involved in the multidisciplinary treatment of cancer know the possible toxicity and its management in oncogeriatric patients; otherwise, the percentage of patients who do not receive radiotherapy despite of an adequate indication will not decrease. In this sense, it is necessary to recognize those patients who may suffer from malnutrition or are at risk of suffering it, to initiate a nutritional intervention that minimizes weight loss that alters or even causes the suspension of the planned treatment

Diet and cancer risk in Mediterranean countries: open issues.

OBJECTIVE: To analyse various aspects of the Mediterranean diet in relation to the risk of several common cancers in Italy. DESIGN: Data from a series of case-control studies conducted in northern Italy between 1983 and 2004 on over 20,000 cases of several major cancers and 18,000 controls. RESULTS: For most digestive tract cancers, the risk decreased with increasing vegetable and fruit consumption, with relative risks between 0.3 and 0.7 for the highest level of intake, and the population-attributable risks for low intake of vegetables and fruit ranged between 15 and 40%. Less strong inverse relations were observed for other (epithelial) cancers, too. A number of micronutrients contained in vegetables and fruit showed an inverse relation with cancer risk. In particular, flavones, flavonols and resveratrol were inversely related to breast cancer risk. Olive oil, which is a typical aspect of the Mediterranean diet, has also been inversely related to cancers of the colorectum and breast, and mainly of the upper digestive and respiratory tract. Consumption of pizza, one of the most typical Italian foods, was related to a reduced risk of digestive tract cancers, although pizza may simply be an aspecific indicator of the Italian diet. CONCLUSIONS: Adherence to the Mediterranean diet is a favourable indicator of the risk of several common epithelial cancers in Italy. A score summarising the major characteristics of the Mediterranean diet was related to a priori defined reduced risks of several digestive tract neoplasms by over 50%.

Efeito de um formulado em pó à base de soja, enriquecido com zinco, selênio e magnésio, em pacientes oncológicos recebendo exclusivamente nutriçäo enteral / Effects of a powder formula, soybean based enriched with zinc, selenium and magnesium, in oncologic patients receiving exclusively enteral nutrition

O presente trabalho objetivou avaliara a eficácia de um formulado desidratado de pó, à base de extrato solúvel de soja enriquecido com selênio, zinco e magnésio (Olygosoy©), de alta qualidade protéica, em pacientes oncológicos recebendo exclusivamente nutrição enteral , a fim de manter e, em alguns casos, recuperar seu estado nutricional. Oito homens e quatro mulheres, com câncer no trato digestivo alto, idade entre 35 e 80 anos, receberam o formulário por 7 a 20 dias. Os valores médios dos pesos, índice de massa corporal, circunferência do braço e circunferência muscular do braço obtidos no final do tratamento foram estatisticamente superiores aos obtidos no início. Houve aumento significativo das proteínas totais, albumina e globulinas. Basófilos, linfócitos e monócitos apresentam diminuição em seus níveis, sendo não-significativa para os basófilos e monócitos. Os pacientes mostraram boa tolerância fisiológica ao formulário.

Cell kinetics of gastrointestinal tumors after different nutritional regimens. A preliminary report.

Forty-four cases of different untreated gastrointestinal tumors were studied with regard to cell kinetic activity. As a pilot experiment, we also determined the 3H-TdR Labeling Index (LI) in 28 patients in basal conditions and after 15 days of nutritional manipulation with prevalently lipid-based or glucose-based feeding to ascertain whether selective nutritional regimens could affect tumor proliferation. Preliminary results from this study indicate that a kinetic perturbation is induced in tumor cells by nutritional manipulation. Lipid-based feeding seems to produce effects similar to those of chemical or physical anticancer agents, thus suggesting a possible supporting role of nutritional manipulation in cancer treatment strategy.