engleski

Review of croatian guidelines for use of eicosapentaenoic acid and megestrol acetate in cancer cachexia syndrome

In 2007, Croatian guidelines were developed for the use of eicosapentaenoic acid and megestrol acetate in cancer cachexia syndrome. These guidelines were first published in the Croatian medical journal Lijecnicki vjesnik (Krznaric et al. Lijec Vjesn 2007 ; 129: 381-6) in Croatian. After numerous contacts and discussions with colleagues from the international medical community, we decided to present our guidelines in English for better exposure and to open our local guidelines for comment and even criticism. It is well known that many oncological patients show a substantial loss of body weight, fat, and proteins, with significant proinflammatory activity at the time of diagnosis. This wasting condition is known as cancer cachexia syndrome. Anorexia is an important part of this syndrome. Cancer cachexia sometimes reduces tumor response to treatment, and it is an indicator of poor prognosis. Because of this we need to start correcting these nutritional deficits immediately. In the presence of cancer cachexia it is extremely difficult to achieve protein anabolism and stop the body wasting, by standard nutritional formulas only. During the last few years, the use of eicosapentaenoic acid and megestrol acetate as anticachectic agents has been tested. These guidelines are intended to give evidence-based recommendations for the use of eicosapentaenoic acid and megestrol acetate in cancer cachexia syndrome. They have been developed by an interdisciplinary expert group of Croatian clinicians. Based on the relevant literature, we have concluded that the simultaneous use of metabolic modulators such as eicosapentaenoic acid and megestrol acetate for 8 weeks may help in improving the nutritional status of cachectic patients. A year after the presentation and implementation of these guidelines we can conclude that despite some shortcomings, they have improved our approach to treating cancer cachexia patients in Croatia.

Anorexia; Cancer cachexia; Eicosapentanoic acid; Guidelines; Megestrol acetate

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