Podpeskar Alexandra, Crazzolara Roman, Kropshofer Gabriele, Hetzer Benjamin, Rabensteiner Evelyn, Meister Bernhard, Obexer Petra, Salvador Christina
Department of Pediatrics I, Division of Hematology and Oncology, Medical University of Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria.
Department of Pediatrics II, Institute of Experimental Neonatology, Medical University of Innsbruck, 6020 Innsbruck, Austria.
Nutrients. 2023 Jul 21;15(14):3239. doi: 10.3390/nu15143239.
As one of the few modifiable risk factors, the importance of dietary patterns for both disease prevention and treatment outcome in pediatric oncology has gained increasing popularity. Malnutrition is associated with lower survival rates, tolerance to treatment, and quality of life. Yet, especially in children with malignancies, nutritional deterioration is common, and pediatric cancer patients often present with inadequate intake of micro- and macronutrients alike. Despite the reported widespread use of dietary supplements, few empirical data provide a basis for clinical recommendations, and evidence for their efficacy is inconsistent. Current literature lacks a systematic approach as to how and which supplements should be recommended for specific patients, types of cancer, or during specific treatments. The aim of this review is to highlight the role of the most frequently used nutrients in pediatric malignant diseases and to give a practical guide based on current scientific evidence.
A comprehensive literature search was conducted on PubMed through April 2023 to select meta-analyses, systematic reviews, observational studies, and individual randomized controlled trials (RCTs) of macro- and micronutrient supplementation in pediatric oncology. The search strategy included the following medical subject headings (MeSH) and keywords: "childhood cancer", "pediatric oncology", "nutritional status", "dietary supplements", "vitamins", "micronutrients", "calcium", "magnesium", "vitamin D", "zinc" "glutamine", "selen", and "omega-3 fatty acids". The reference lists of all relevant articles were screened to include potentially pertinent studies.
The present review provides a comprehensive and updated overview of the latest evidence about the role of nutrition and diet in pediatric oncology, also focusing on different nutritional interventions available for the management of the disease. We summarize evidence about the importance of adequate nutrition in childhood cancer and the role of several micronutrients and critically interpret the findings. Possible effects and benefits of supplementation during chemotherapy are discussed, as are strategies for primary and secondary prevention.
We here describe the obvious benefits of dietary supplementation for childhood cancer. Further large-scale clinical trials are required to verify the impacts of deficiencies and the possible benefits of supplementation and optimal dosages. (337 words).
作为少数可改变的风险因素之一，饮食模式在儿童肿瘤学疾病预防和治疗结果方面的重要性日益受到关注。营养不良与较低的生存率、对治疗的耐受性以及生活质量相关。然而，尤其是在患有恶性肿瘤的儿童中，营养恶化很常见，儿科癌症患者通常同时存在微量营养素和宏量营养素摄入不足的情况。尽管有报道称膳食补充剂被广泛使用，但很少有实证数据为临床建议提供依据，且其疗效证据并不一致。目前的文献缺乏关于如何以及应为特定患者、癌症类型或特定治疗推荐何种补充剂的系统方法。本综述的目的是强调最常用营养素在儿童恶性疾病中的作用，并根据当前科学证据提供实用指南。
截至2023年4月，在PubMed上进行了全面的文献检索，以选择关于儿童肿瘤学中宏量和微量营养素补充的荟萃分析、系统评价、观察性研究和个体随机对照试验（RCT）。检索策略包括以下医学主题词（MeSH）和关键词：“儿童癌症”、“儿科肿瘤学”、“营养状况”、“膳食补充剂”、“维生素”、“微量营养素”、“钙”、“镁”、“维生素D”、“锌”、“谷氨酰胺”、“硒”和“ω-3脂肪酸”。对所有相关文章的参考文献列表进行筛选，以纳入可能相关的研究。
本综述提供了关于营养和饮食在儿科肿瘤学中作用的最新证据的全面且更新的概述，还重点关注了可用于疾病管理的不同营养干预措施。我们总结了关于儿童癌症中充足营养的重要性以及几种微量营养素的作用的证据，并对研究结果进行了批判性解读。讨论了化疗期间补充剂的可能效果和益处，以及一级和二级预防策略。
我们在此描述了膳食补充剂对儿童癌症的明显益处。需要进一步的大规模临床试验来验证营养素缺乏的影响以及补充剂的可能益处和最佳剂量。（337字）
