Viani Karina, Albuquerque Luiza, Barr Ronald D, Ladas Elena J
Instituto de Tratamento do Câncer Infantil, Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
McMaster University, Hamilton, Ontario, Canada.
JCO Glob Oncol. 2020 Feb;6:242-259. doi: 10.1200/JGO.19.00285.
The objective of this systematic review was to describe nutrition-related publications on children and adolescents diagnosed with cancer in Brazil.
The methodology followed that of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Medline, LILACS (the Latin American & Caribbean Health Sciences Literature), and Embase were searched in April 2019, and data extraction and rating of methodologic study quality (according to the National Institutes of Health quality score assessment) were performed independently by reviewers.
Twenty-seven studies met the inclusion criteria, reporting on 3,509 patients from 1994 to 2018. Most of the studies (74%) were of poor quality in methodology and reporting. Different cancer diagnoses were included in 52% of studies, whereas acute leukemia was the exclusive focus in 41%. The majority of the articles (70%) were from institutions in the Southeast Region of Brazil, mainly the state of São Paulo (74%); no publications were from the North Region of the country. Twelve studies addressed nutritional status and body composition, reporting an abundance of malnourished patients in the Brazilian population of children and adolescents with cancer. Six studies on micronutrients pointed to possible deficiencies in this population, with a yet unclear but promising role for supplementation during treatment.
Evidence indicates that there is great interest in the impact of nutrition on childhood cancer treatment and clinical outcomes in Brazil. However, there is a need to focus on high-quality research, particularly with multicentric/national studies. This will help establish research priorities and better planned clinical interventions, adapted to each region of the country.
本系统评价的目的是描述巴西有关诊断为癌症的儿童和青少年的营养相关出版物。
采用系统评价和荟萃分析的首选报告项目方法。于2019年4月检索了医学文献数据库（Medline）、拉丁美洲和加勒比卫生科学文献数据库（LILACS）以及荷兰医学文摘数据库（Embase），由评审人员独立进行数据提取和方法学研究质量评分（根据美国国立卫生研究院质量评分评估）。
27项研究符合纳入标准，报告了1994年至2018年的3509例患者。大多数研究（74%）在方法学和报告方面质量较差。52%的研究纳入了不同的癌症诊断，而41%的研究仅聚焦于急性白血病。大多数文章（70%）来自巴西东南部地区的机构，主要是圣保罗州（74%）；该国北部地区没有相关出版物。12项研究涉及营养状况和身体成分，报告了巴西癌症儿童和青少年人群中营养不良患者众多。6项关于微量营养素的研究指出该人群可能存在缺乏情况，治疗期间补充的作用尚不清楚但前景良好。
有证据表明，巴西对营养对儿童癌症治疗和临床结局的影响非常关注。然而，需要专注于高质量研究，特别是多中心/全国性研究。这将有助于确定研究重点并更好地规划临床干预措施，以适应该国各地区的情况。
