Fan Xiaomei, Cui Huixia, Liu Shasha
Department of Nursing, Jinzhou Medical University, Jinzhou, China.
First Affiliated Hospital of Chengdu Medical College, Chengdu, China.
Front Nutr. 2024 Jul 31;11:1413117. doi: 10.3389/fnut.2024.1413117. eCollection 2024.
To evaluate and summarize the best evidence for nutritional support in patients receiving radiotherapy for nasopharyngeal carcinoma and to offer guidance for clinical practice.
Patients with nasopharyngeal carcinoma undergoing radiotherapy often experience a high prevalence of malnutrition, and there is a lack of compiled guideline recommendations, which complicates the provision of a reference for clinical nursing.
A systematic literature search revealed the best evidence of nutritional support for nasopharyngeal carcinoma patients undergoing radiotherapy. Included in the review were various types of literature, such as clinical guidelines, expert consensus, systematic evaluations, meta-analyses, evidence summaries, and original studies. The evidence was graded according to the Australian Joanna Briggs Institute Centre for Evidence-Based Health Care Evidence Pre-Grading System (2016 version). Data were gathered from a range of sources, including BMJ Best Practice, the Scottish Intercollegiate Guidelines Network, the Cochrane Library, Embase, PubMed, Web of Science, CINAL, CNKI, the WanFang database, SinoMed, the Yi Maitong Guidelines Network, Dingxiangyuan, the Chinese Nutrition Society, the European Society for Clinical Nutrition and Metabolism website, and the American Society for Parenteral and Enteral Nutrition website. The search spanned from January 2013 to 2023.
A comprehensive review identified a total of 3,207 articles, comprising six guidelines, eight expert consensus articles, four systematic evaluations, five randomized controlled trials, two cohort trials, and two observational studies. From these articles, we synthesized 63 pieces of evidence spanning six domains: nutritional risk screening and assessment, nutrient requirements, nutritional support, management of nutritional symptoms, functional exercise, and nutritional monitoring and follow-up.
A total of lines of evidence supporting nutritional support for nasopharyngeal carcinoma patients receiving radiotherapy were summarized. However, the evidence should be combined with the actual clinical situation, and it should be validated in the future by combining large-sample and multicenter studies to provide a more scientific and beneficial nutritional support program for nasopharyngeal carcinoma patients receiving radiotherapy.
评估并总结鼻咽癌放疗患者营养支持的最佳证据，为临床实践提供指导。
鼻咽癌放疗患者常出现高营养不良发生率，且缺乏汇编的指南推荐，这使得为临床护理提供参考变得复杂。
系统文献检索揭示了鼻咽癌放疗患者营养支持的最佳证据。纳入综述的文献类型多样，如临床指南、专家共识、系统评价、荟萃分析、证据总结和原始研究。证据根据澳大利亚乔安娜·布里格斯循证卫生保健中心证据预分级系统（2016版）进行分级。数据从一系列来源收集，包括BMJ最佳实践、苏格兰校际指南网络、考克兰图书馆、Embase、PubMed、科学网、CINAL、中国知网、万方数据库、中国生物医学文献数据库、医脉通指南网络、丁香园、中国营养学会、欧洲临床营养与代谢学会网站以及美国肠外与肠内营养学会网站。检索时间跨度为2013年1月至2023年。
全面综述共识别出3207篇文章，包括6篇指南、8篇专家共识文章、4篇系统评价、5项随机对照试验、2项队列试验和2项观察性研究。从这些文章中，我们综合了63条证据，涵盖六个领域：营养风险筛查与评估、营养需求、营养支持、营养症状管理、功能锻炼以及营养监测与随访。
总结了支持鼻咽癌放疗患者营养支持的一系列证据。然而，这些证据应结合实际临床情况，并在未来通过大样本和多中心研究进行验证，以为鼻咽癌放疗患者提供更科学、有益的营养支持方案。
