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Mikronährstoffsupplemente bei onkologischen Patienten

Rationale für die Empfehlung

Micronutrient supplementation for cancer patients

Rationale for recommendations

  • Leitthema
  • Published:
Der Onkologe Aims and scope

Zusammenfassung

Vitamine, Minerale und Spurenelemente, insbesondere Antioxidanzien, werden von bis zu 70% der onkologischen Patienten in unterschiedlichsten Kombinationen und Konzentrationen eingenommen. Die Rationale für die Einnahme ist unterschiedlich und oft auch unbegründet. Während normal dosierte Mikronährstoffpräparate aufgrund der oft bestehenden Mangelernährung unkritisch sind, ist bei den vielfach empfohlenen hoch dosierten Präparaten, v. a. den Antioxidanzien, die Datenlage unklar und es ist nicht sicher, inwieweit hier statt des positiven Effekts ein negativer eintreten kann. Die Radio- und Chemotherapie wirkt unter anderem über die Bildung reaktiver Sauerstoffverbindungen (ROS), die wiederum durch Antioxidanzien abgefangen werden. ROS sind aber auch für Nebenwirkungen mitverantwortlich, sodass Antioxidanzien hier eher nützlich sein könnten. Dies gilt es bei der Beurteilung der wissenschaftlichen Evidenz für den Einsatz von Antioxidanzien abzuwägen.

Abstract

Vitamins, minerals, trace elements, and especially antioxidants in different combinations and concentrations are taken by 70% of oncological patients. The reasons they consume these micronutrients differ and in many cases are not justified. Multivitamin supplements within a normal range (100% of dietary reference intake) are without any risk for cancer patients; indeed, because these individuals are frequently malnourished, such supplements might be beneficial. However, antioxidants in high concentrations, which are frequently recommended, might be either beneficial or harmful. Radiotherapy and chemotherapy exert some effects on cancer cells via generation of reactive oxygen species (ROS). Antioxidants may neutralise ROS and consequently have a harmful effect regarding therapeutic efficacy. On the other hand, ROS are in part also responsible for side effects of radio- and chemotherapy, so antioxidants might be beneficial. If antioxidants are recommended to cancer patients, these factors must be kept in mind and critically analysed.

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  1. Institut für Biologische Chemie und Ernährungswissenschaft, Universität Stuttgart-Hohenheim, Garbenstraße 30, 70593, Stuttgart, Deutschland

    H.-K. Biesalski

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Biesalski, HK. Mikronährstoffsupplemente bei onkologischen Patienten. Onkologe 14, 45–57 (2008). https://doi.org/10.1007/s00761-007-1291-z

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