Departments of Pediatrics and Medicine, McMaster University, Hamilton, Canada.
Unidad Nacional de Oncología Pediátrica, and School of Medicine, Francisco Marroquín University, Guatemala, Guatemala.
Hematology. 2022 Dec;27(1):987-993. doi: 10.1080/16078454.2022.2115437.
: The primary purpose of this review is to investigate the relationships between cancer and nutrition in children and adolescents living in resource-poor, low- and middle-income countries (LMICs) in order to explore potential opportunities for interventions which could improve clinical outcomes in this population.
: The implications of overlapping age groups of children and adolescents with cancer are examined, as are the adverse influences of under-nutrition and socio-economic deprivation on the efficacy of treatment and cancer survival. Evidence suggestive of novel avenues to enhance prospects for cure, based on increased understanding of the dynamic of nutrition and cancer, is evaluated.
: Cancer adds to the burden of under-nutrition in disadvantaged populations which is reflective, in large measure, on inadequate governmental expenditure on health which demands public-private partnerships and the use of hospital-based foundations. Structured approaches to the measurement of nutritional status and the design of effective programmes of nutritional supplementation are of proven benefit. Initial results from studies of the perturbed gut microbiome hold considerable promise for further gains.
A large minority of children with cancer in LMICs are never diagnosed and the same may be true of adolescents. Investing in the training of nutritionists will have substantial returns as will increasing access to essential medicines. Recognition of these challenges has stimulated WHO and other entities to devise major strategies for comprehensive changes in the care of children and adolescents with cancer in LMICs, offering realistic prospects for improved clinical outcomes.
本综述的主要目的是研究资源匮乏、中低收入国家（LMICs）中儿童和青少年癌症与营养之间的关系，以探索潜在的干预机会，从而改善该人群的临床结局。
本文考察了癌症患儿和青少年重叠年龄组的影响，以及营养不良和社会经济剥夺对治疗效果和癌症生存的不利影响。评估了基于对营养与癌症动态关系的深入理解，为提高治愈前景而开辟新途径的证据。
癌症加重了贫困人群的营养不良负担，这在很大程度上反映了政府在卫生保健方面的支出不足，需要公私伙伴关系和利用医院基金会。对营养状况进行结构化评估和设计有效的营养补充方案已被证明是有益的。对紊乱肠道微生物组的初步研究结果为进一步取得进展带来了巨大希望。
在 LMICs 中，只有少数儿童癌症患者得到诊断，青少年可能也是如此。投资于营养学家的培训将带来巨大的回报，增加获得基本药物的机会也是如此。对这些挑战的认识促使世卫组织和其他实体制定了全面改变中低收入国家儿童和青少年癌症护理的主要战略，为改善临床结局提供了现实的前景。
