| 标题： | 中国癌因性厌食诊疗专家共识 |
| title： | Chinese Expert Consensus on the Diagnosis and Treatment of Cancer-Related Anorexia |
| 版本： | 原创版 |
| version： | Original |
| 分类： | 专家共识 |
| classification： | Experts consensus |
| 领域： | 诊疗 |
| field： | Diagnosis and Treatment |
| 国家和地区： | 中国 |
| Country and region： | China |
| 指南使用者： | 临床医生 |
| Guide users： | Clinical physicians |
| 证据分级方法： | 按共识制定要求，对癌因性厌食领域文献进行检索、筛选和梳理，基于循证医学证据并结合专家组临床经验形成共识内容。 证据类别标准 证据特征 专家共识度 类别 水平 来源 1A 高 严谨的Meta分析、大型随机对照研究 一致共识 (支持意见≥80%) 1B 高 严谨的Meta分析、大型随机对照研究 基本一致共识，争议小 (支持意见60%~80%) 2A 稍低 一般质量的Meta分析、小型随机对照研究、设计良好的大型回顾性研究、病例对照研究 一致共识 (支持意见≥ 80%) 2B 稍低 一般质量的Meta分析、小型随机对照研究、设计良好的大型回顾性研究、病例对照研究 基本一致共识，争议小 (支持意见 60%~80%) 3 低 非对照的单臂临床研究、病例报告、专家观点 无共识，且争议大 (支持意见<60%) 推荐等级标准 推荐等级 推荐标准 I级推荐 1A类证据和部分2A类证据 将1A类证据，以及部分专家共识度高且在中国可及性好的2A类证据作为I级推荐。 II级推荐 1B 类证据和部分2A类证据 将1B类证据，以及部分在中国可及性欠佳，但专家共识度较高的2A类证据，作为II级推荐。 III级推荐 2B类证据和3类证据 对于某些临床上习惯使用，或有探索价值的诊治措施，虽然循证医学证据相对不足，但专家组意见认为可以接受的，作为III级推荐。 |
| Evidence grading method： | According to the requirements set by the consensus, a literature search, screening, and collation were conducted in the field of cancer-related anorexia. Based on evidence-based medicine and combined with the clinical experience of the expert group, the content of the consensus was formed. Evidence Category Standards Evidence Characteristics | Consensus Degree Category | Level | Source 1A | High | Rigorous meta-analysis, large randomized controlled trials | Consensus (Support ≥80%) 1B | High | Rigorous meta-analysis, large randomized controlled trials | Basic consensus with minor controversy (Support 60%-80%) 2A | Slightly lower | General quality meta-analysis, small randomized controlled trials, well-designed large retrospective studies, case-control studies | Consensus (Support ≥80%) 2B | Slightly lower | General quality meta-analysis, small randomized controlled trials, well-designed large retrospective studies, case-control studies | Basic consensus with minor controversy (Support 60%-80%) 3 | Low | Uncontrolled single-arm clinical studies, case reports, expert opinions | No consensus with significant controversy (Support <60%) Recommendation Level Standards Recommendation Level | Recommendation Criteria Level I Recommendation | Evidence of Category 1A and some Category 2A Category 1A evidence, as well as some Category 2A evidence with high consensus and good accessibility in China, are considered as Level I recommendations. Level II Recommendation | Evidence of Category 1B and some Category 2A Category 1B evidence, as well as some Category 2A evidence with high consensus but poor accessibility in China, are considered as Level II recommendations. Level III Recommendation | Evidence of Category 2B and Category 3 For some diagnostic and treatment measures that are commonly used in clinical practice or have exploratory value, although the evidence-based medical evidence is relatively insufficient, if the expert group considers them acceptable, they are considered as Level III recommendations. |
| 制定单位： | 中国临床肿瘤学会肿瘤支持和康复专家委员会 |
| Formulating unit： | Chinese Society of Clinical Oncology Committee of Supportive and Rehabilitative Care |
| 注册时间： | 2024-11-04 |
| Registration time： | |
| 注册编号： | PREPARE-2024CN028 |
| Registration number： | |
| 指南制订的目的： | 癌因性厌食是指因肿瘤本身和/或其治疗所引发的食欲减退或丧失。癌因性厌食由多个症状构成，例如：厌食、恶心、味觉改变、早饱或吞咽困难。研究表明超过75%的中晚期肿瘤患者存在癌因性厌食症状，超过半数的肿瘤患者对厌食和/或体重减轻表示担忧。食欲减退不仅影响患者的营养状态，还与生存时间缩短、抗肿瘤治疗依从性降低、治疗相关副作用增加，以及生活质量下降等多种严重不良事件紧密相关。目前癌因性厌食普遍存在但临床中易被忽视，对于癌因性厌食的发病机制仍缺乏充分的理解，其筛查与诊断流程标准暂未统一，对于干预时机与治疗方式尚未形成广泛共识。为了规范癌因性厌食诊疗的流程以指导临床和科研工作，中国临床肿瘤学会肿瘤支持和康复专家委员会（SCRC）邀请我国相关领域专家进行《中国癌因性厌食专家共识》的制定工作。本共识将成为临床医生诊疗癌因性厌食的重要参考，更好地规范癌因性厌食诊疗，积极筛查、早期干预和规范治疗，使更多患者获益。 |
| Purpose of the guideline： | Cancer cachexia is defined as the loss of appetite or anorexia caused by the tumor itself and/or its treatment. Cancer cachexia consists of multiple symptoms, such as anorexia, nausea, taste changes, early satiety, or difficulty swallowing. Studies have shown that over 75% of patients with advanced-stage tumors have symptoms of cancer cachexia, and more than half of cancer patients express concern about anorexia and/or weight loss. Reduced appetite not only affects the nutritional status of patients but is also closely associated with a shortened survival time, reduced compliance with anti-tumor treatment, increased treatment-related side effects, and a decline in quality of life, among other serious adverse events. Currently, cancer cachexia is prevalent but often overlooked in clinical practice, and there is still a lack of sufficient understanding of its pathogenesis. The standards for screening and diagnostic processes have not been unified, and there is no widespread consensus on the timing of intervention and treatment methods. To standardize the diagnosis and treatment process of cancer cachexia to guide clinical and research work, the Support and Rehabilitation Expert Committee (SCRC) of the Chinese Society of Clinical Oncology (CSCO) has invited experts in related fields in China to formulate the "Chinese Expert Consensus on Cancer Cachexia." This consensus will become an important reference for clinical physicians in the diagnosis and treatment of cancer cachexia, better standardize the diagnosis and treatment of cancer cachexia, actively screen, intervene early, and standardize treatment, benefiting more patients. |
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