Zusammenfassung
Fragestellung
Gibt es evidenzbasierte Behandlungsansätze für den Umgang mit Mikronährstoffen in der urologischen Onkologie?
Methode
Die bestehenden S3-Leitlinien „Supportive Therapie“, „Komplementärmedizin“ und die Online-Plattform Onkopedia werden zu den einzelnen Spurenelementen (Zn, Se, Mn, Fe), Vitaminen (A, B, C, D, E) und Elektrolyten (Mg, Ca) durchsucht, die Aussagen zusammengestellt und um andere, in Studien geprüfte Ansätze in diesem Bereich erweitert.
Ergebnisse
Einer Therapie mit Mikronährstoffen sollte eine Serumbestimmung vorausgehen. Für Selen, Eisen und Vitamin D gibt es Leitlinienempfehlungen. Potenzielle Indikationen lassen sich aus kleineren Untersuchungen für Mangan, Vitamin A und C ableiten. Kein Benefit wird für Zink, Vitamin B und E gesehen.
Schlussfolgerung
Mikronährstoffe sollten bei Mangel immer substituiert werden. Von einer generellen Supplementation der Nahrung wird auch im urologischen Bereich abgeraten.
Abstract
Objective
Are there any evidence-based medicine (EBM)-supported treatment approaches of complementary and alternative medicine (CAM) methods for urological oncologists?
Methods
We reviewed the actual German S3 guidelines “Supportive Care” and “Complementary Medicine” as well as the online-tool Onkopedia for recommendations about essential trace elements (Zn, Se, Mn, Fe), vitamins (A, B, C, D, E), and electrolytes (Mg, Ca). Furthermore, we added results of randomized trials to present potential future developments.
Results
Each therapy with micronutrients should be based on laboratory observation of a deficit. There are selected guideline recommendations for selenium, iron and vitamin D. Potential indications were registered for manganese, vitamin A derivates, and vitamin C. No benefit was observed for vitamin B, zinc, and vitamin E.
Conclusion
Micronutrients should be substituted in the case of deficit. General supplementation of daily nutrition is not recommended for cancer patients.
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J. Büntzel, R. Mücke, K. Kisters und O. Micke geben an, dass kein Interessenkonflikt besteht.
Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.
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Büntzel, J., Mücke, R., Kisters, K. et al. Essentielle Spurenelemente, Vitamine und ausgewählte Elektrolyte in der Komplementärmedizin für Tumorpatienten. Urologie 62, 12–16 (2023). https://doi.org/10.1007/s00120-022-01985-3
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DOI: https://doi.org/10.1007/s00120-022-01985-3