Systematic review and meta-analysis confirm evidence for oral nutritional intervention on nutritional and clinical outcomes during chemo(radio)therapy
Cancer-related malnutrition frequently develops, with
prevalence ranging from 30% to 90% depending on tumor site, stage of disease
and treatment. Major causes are cancer-induced metabolic alterations and/or
cancer-induced symptoms (e.g. anorexia, nausea, pain) resulting in decreased
food intake. Malnutrition can be exacerbated by the side-effects of anticancer
drugs such as fatigue, anorexia, altered hedonic input and a wide range of GI
symptoms, and/or by physical inactivity resulting from physical and
psychosocial distress, which may lead to further loss of muscle mass.
Malnutrition impairs tolerance to anticancer treatments including chemotherapy
and is associated with decreased response to treatment, decreased quality of
life (QoL) and shorter survival
Driven by reduced intake and metabolic alterations,
cancer-related malnutrition negatively impacts clinical outcomes. A systematic
review suggests an overall positive effect of nutritional interventions during
chemo(radio)therapy on body weight. Subgroup analyses showed effects were
driven by high-protein n-3 PUFA-enriched
oral nutritional supplements (ONS), suggesting the benefit of targeting
metabolic alterations. Dietary counseling and/or high-energy ONS were less
effective, likely due to cumulative caloric deficits despite interventions.
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