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[Adjuvant parenteral nutrition in chemo- and radiotherapeutic measures in hematology]
Abstract:
The study investigates clinical nutrition of oncological patients as an essential adjuvant component in the whole therapeutical concept. The main subject of the study was the transfer of nutritional concepts which were developed in non-malignant diseases to oncological patients. We defined the homeostasis of patients by biochemical and biophysical parameters in blood (osmolality, Na, K, total protein, albumin, triglycerides, NEFA, glucose, lactate, creatinine, urea, total nitrogen, amino acids) and urine (volume, osmolality, Na, K, creatinine, urea, total nitrogen, and amino acids). Of special interest was the homeostasis of nitrogen, which was characterized by the loss of nitrogen and nitrogen balances. 10 patients with either transplantable panmyeolopathy or leukemia were investigated including a phase of immunsupressive treatment by total body radiation and cytostatic treatment. Parenteral nutrition was made with amino acids (1 g/kg/d), carbohydrates (6.5 g/kg/d) and fat (1 g/kg/d). During the preparatory phase nutrition was interrupted for two consecutive days because high amounts of electrolyte solution with up to 6 1/day were needed to protect the kidney. The period of investigation covered the complete period of treatment which endured up to three months. The essential result was the achievement of a constant body weight which decreased drastically under the conventional treatment without optimized nutrition. The homeostasis remained unchanged inspite of the fact that great changes occurred individually. Nitrogen balance and nitrogen loss demonstrate the strong influence of immun-suppresive treatment with N-losses of up to 20 g per day.(ABSTRACT TRUNCATED AT 250 WORDS)