Institute for Physical Activity and Nutrition, Deakin University, Locked Bag 20001, Geelong, VIC 3220, Australia.
Peter McCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC 3000, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Grattan Street, Parkville, VIC 3010, Australia.
Maturitas. 2024 May;183:107938. doi: 10.1016/j.maturitas.2024.107938. Epub 2024 Feb 10.
Most women with ovarian cancer are diagnosed at an advanced stage (stage III or IV), when the intraabdominal spread of the tumour impacts nutrient intake and absorption. Up to 70 % of women with ovarian cancer are malnourished and approximately 40 % are affected by muscle loss at the time of diagnosis. Women with ovarian cancer are at high risk of nutritional decline due to invasive treatment and the severity of side-effects. This review explores the evidence evaluating nutritional interventions during treatment for ovarian cancer and their effect on nutritional status, muscle mass, and clinical outcomes. Perioperative immunonutrition has been investigated with mixed results for immediate postoperative outcomes. Individualised nutrition counselling as part of a multimodal prehabilitation programme prior to surgery shows promising results; however, the effects are limited by sample size. Nutrition counselling as part of a mixed intervention with exercise shows high acceptability and suggests improvements in dietary intake and quality of life during chemotherapy treatment, while oral nutritional supplements and nutrition education appear to reduce symptom burden. Individualised nutrition counselling during treatment also appears to be associated with improved overall survival; however, the evidence is limited to a single retrospective study. A key finding from this review is that, despite the high prevalence of malnutrition and muscle loss in women with ovarian cancer and the critical importance of addressing these modifiable prognostic factors, nutrition intervention studies are limited. Prospective studies with samples large enough to provide adequate power to evaluate intervention effectiveness are urgently required to inform optimal management.
大多数卵巢癌患者在晚期（III 期或 IV 期）被诊断出来，此时肿瘤的腹腔内扩散会影响营养摄入和吸收。多达 70%的卵巢癌患者存在营养不良的情况，约 40%的患者在确诊时就出现肌肉减少的情况。由于侵袭性治疗和严重的副作用，卵巢癌患者存在营养状况恶化的高风险。本综述探讨了评估卵巢癌治疗期间营养干预措施及其对营养状况、肌肉质量和临床结局影响的证据。围手术期免疫营养对术后即刻结果的影响存在差异。在手术前作为多模式预康复计划的一部分进行个体化营养咨询显示出有希望的结果；然而，由于样本量的限制，其效果有限。作为包含运动的混合干预措施的一部分进行营养咨询表明，在化疗期间接受营养咨询可提高饮食摄入量和生活质量，同时口服营养补充剂和营养教育似乎可减轻症状负担。治疗期间的个体化营养咨询似乎也与总体生存改善有关；然而，证据仅限于一项回顾性研究。本综述的一个重要发现是，尽管卵巢癌患者普遍存在营养不良和肌肉减少的情况，且解决这些可改变的预后因素至关重要，但营养干预研究却很有限。迫切需要进行有足够样本量的前瞻性研究，以评估干预措施的有效性，为最佳管理提供信息。
