Undergraduate Programme in Nutrition, Federal University of Santa Catarina, Campus Universitario Trindade, 88040970, Florianopolis, Santa Catarina, Brazil.
Postgraduate Programme in Neuroscience, Federal University of Santa Catarina, Campus Universitario Trindade, 88040970, Florianopolis, Santa Catarina, Brazil.
Br J Nutr. 2021 Mar 14;125(5):530-547. doi: 10.1017/S0007114520002329. Epub 2020 Jun 29.
Oral nutritional supplements are widely recommended to head-and-neck cancer patients undergoing anti-cancer treatment; however, their effects on the outcomes of most importance to patients are unclear. This study aimed to systematically review the evidence of effect of oral nutritional supplements on mortality, treatment tolerance, quality of life, functional status, body weight and adverse effects. We searched PubMed, Embase, CENTRAL, LILACS, Web of Science, CINAHL, two trial registry platforms, three sources of grey literature and reference lists of included studies. We assessed the risk of bias using the revised Cochrane risk-of-bias tool (RoB 2), and certainty of evidence using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. We used random-effects models with Hartung-Knapp correction for the meta-analyses. We included fifteen trials, of which five were ongoing or unpublished, providing evidence in four comparisons. We found very low to low certainty evidence for the effect of oral nutritional supplements on mortality, treatment tolerance, quality of life, functional status and adverse effects. When compared with nutritional counselling alone, nutritional counselling plus oral nutritional supplements probably increased body weight slightly. We also found adverse events relating to supplements use such as nausea, vomiting and feeling of fullness. Possible increases in mortality, treatment tolerance and quality of life besides a possible decrease in functional status are worthy of further investigation. Future research could attempt to address the clinical importance of a probable increase in body weight. Possible adverse effects of the use of oral nutritional supplements should not be overlooked.
口服营养补充剂广泛推荐给正在接受抗癌治疗的头颈部癌症患者；然而，它们对患者最重要的结局的影响尚不清楚。本研究旨在系统评价口服营养补充剂对死亡率、治疗耐受性、生活质量、功能状态、体重和不良反应的影响。我们检索了 PubMed、Embase、CENTRAL、LILACS、Web of Science、CINAHL、两个试验注册平台、三个灰色文献来源和纳入研究的参考文献列表。我们使用修订后的 Cochrane 偏倚风险工具（RoB 2）评估偏倚风险，并使用 GRADE（推荐评估、制定和评价）方法评估证据确定性。我们使用随机效应模型和 Hartung-Knapp 校正进行荟萃分析。我们纳入了十五项试验，其中五项正在进行或未发表，提供了四项比较的证据。我们发现口服营养补充剂对死亡率、治疗耐受性、生活质量、功能状态和不良反应的影响的证据确定性为极低至低。与单独营养咨询相比，营养咨询加口服营养补充剂可能会使体重略有增加。我们还发现了与补充剂使用相关的不良反应，如恶心、呕吐和饱腹感。除了可能降低功能状态外，死亡率、治疗耐受性和生活质量的可能增加值得进一步研究。未来的研究可以尝试解决体重可能增加的临床重要性问题。不应忽视口服营养补充剂使用的可能不良反应。
