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改善头颈癌患者短期预后的营养干预措施的系统评价

Systematic Review of Nutrition Interventions to Improve Short Term Outcomes in Head and Neck Cancer Patients.

作者信息

Leis Claire, Arthur Anna E, Chen Xin, Greene Michael W, Frugé Andrew D

机构信息

Department of Nutritional Sciences, Auburn University, Auburn, AL 36849, USA.

Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, KS 66160, USA.

出版信息

Cancers (Basel). 2023 Jan 29;15(3):822. doi: 10.3390/cancers15030822.

Abstract

Head and neck cancer (HNC) is associated with high rates of malnutrition. We conducted a systematic review and descriptive analysis to determine the effects of nutrition interventions on the nutrition status, quality of life (QOL), and treatment tolerance of HNC patients. PubMed, Web of Science, and Embase were searched to include all potentially relevant studies published between 2006-2022. Meta-analysis was not conducted due to heterogeneity of study designs and outcomes reported. Studies were categorized as nutrition interventions: (1) with oral nutrition supplements (ONS) and medical nutrition therapy (MNT) delivered by an RD; (2) with enteral nutrition (EN) support and MNT delivered by an RD; (3) with motivational interviewing and no ONS or EN; and (4) with ONS and no RD. Seven articles met inclusion criteria. Studies measured outcomes from immediately following treatment to 12 months post-treatment. Interventions resulted in benefits to lean mass/weight maintenance (three studies), QOL (two studies), nutrient intake adequacy (one study) and treatment tolerance (two studies). Nutrition counseling by a registered dietitian leads to improved nutrition status and QOL. Further research is needed to determine best practices related to timing of initiation, duration of nutrition intervention, as well as frequency of dietitian follow-up.

摘要

头颈癌(HNC)与高营养不良率相关。我们进行了一项系统综述和描述性分析,以确定营养干预对头颈癌患者营养状况、生活质量(QOL)和治疗耐受性的影响。检索了PubMed、科学网和Embase,纳入2006年至2022年期间发表的所有潜在相关研究。由于研究设计和报告结果的异质性,未进行荟萃分析。研究分为营养干预:(1)使用口服营养补充剂(ONS)和由注册营养师提供的医学营养治疗(MNT);(2)使用肠内营养(EN)支持和由注册营养师提供的MNT;(3)采用动机性访谈且不使用ONS或EN;(4)使用ONS且无注册营养师参与。七篇文章符合纳入标准。研究测量了从治疗后立即到治疗后12个月的结果。干预对头颈部肌肉量/体重维持(三项研究)、生活质量(两项研究)、营养素摄入充足性(一项研究)和治疗耐受性(两项研究)产生了有益影响。由注册营养师提供的营养咨询可改善营养状况和生活质量。需要进一步研究以确定与营养干预开始时间、持续时间以及营养师随访频率相关的最佳实践。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cc6/9913111/0644b22fa8c3/cancers-15-00822-g001.jpg

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