Cáncer de cabeza y cuello: revisión del diagnóstico y tratamiento de la sarcopenia
DOI:
https://doi.org/10.12873/443cacicedoPalavras-chave:
Toxicidad, Supervivencia, Valoración nutricional, Ejercicio físico, SarcopeniaResumo
Introducción: Los pacientes con cáncer de cabeza y cuello (CCC) pueden presentar tumores que se originan en la mucosa y/o submucosa que recubre la cavidad oral, faríngea y laríngea, dando lugar a síntomas que impactan habitualmente en la deglución y favorecen los problemas nutricionales de estos pacientes. Hasta un 52% de los enfermos presentan desnutrición al diagnóstico, incrementándose hasta cerca del 90% durante la terapia antineoplásica. Por lo que, son uno de los grupos más vulnerables para desarrollar sarcopenia asociada a la desnutrición y disfagia. El objetivo es revisar el conocimiento actual sobre el estado de la masa muscular, la patogénesis, diagnóstico y tratamiento de la sarcopenia cuando tiene lugar en el cáncer de cabeza y cuello.
Métodos: Búsqueda bibliográfica en bases de datos PubMed-Medline de artículos entre 2015 y 2022 con términos previamente definidos.
Resultados: Los pacientes con cáncer de cabeza y cuello constituyen un grupo heterogéneo en el que la prevalencia de desnutrición es significativa pero muy variable. Se han desarrollado varios métodos diagnósticos para evaluar la masa muscular en pacientes oncológicos, pero todavía no están estandarizados. Además, no existe una pauta farmacológica concreta para el tratamiento de la sarcopenia o la caquexia a nivel clínico.
Conclusión: La valoración nutricional debe ser una parte fundamental del enfoque inicial del paciente oncológico y posterior seguimiento. El objetivo terapéutico es aumentar el apetito y la ingesta de alimentos, atenuar el estado inflamatorio crónico y mejorar la capacidad y la calidad del ejercicio.
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