Vella Roberta, Pizzocaro Erica, Bannone Elisa, Gualtieri Paola, Frank Giulia, Giardino Alessandro, Frigerio Isabella, Pastorelli Davide, Gruttadauria Salvatore, Mazzali Gloria, di Renzo Laura, Butturini Giovanni
Department of Hepato-Pancreato-Biliary Unit, Pederzoli Hospital, 37019 Peschiera del Garda, Italy.
Department of Precision Medicine in the Medical, Surgical and Critical Care Area, University of Palermo, 90127 Palermo, Italy.
Cancers (Basel). 2024 Aug 9;16(16):2809. doi: 10.3390/cancers16162809.
This study aims to review existing literature on the effect of oral nutritional supplements (ONSs) during chemotherapy in older cancer patients. Electronic databases were searched for relevant studies up to March 2024. The risk of bias in the included studies was evaluated using the Cochrane tool. Eligible studies included randomized, prospective, and retrospective studies evaluating the effect of ONSs in elderly (median age > 65 years) cancer patients during chemotherapy. Data regarding chemotherapy adherence, toxicity, overall survival, and nutritional status were extracted. A total of ten studies, involving 1123 patients, were included. A meta-analysis of the results was not conducted due to the scarcity and heterogeneity of results. Some ONSs were associated with reduced incidence of chemotherapy side-effects, particularly oral mucositis, and improved nutritional status. There was limited or no evidence regarding the impact of ONSs on chemotherapy adherence or overall survival. Various types of ONS were investigated, including multimodal intervention with tailored nutritional counseling, whey protein supplements, amino acids supplements (including immune nutrition supplements), and fish oil omega-3-enriched supplements. ONSs showed promise in reducing chemotherapy side-effects and improving nutritional status in older cancer patients, but further studies are needed to explore their efficacy on chemotherapy adherence and overall survival. Future research should consider both chronological age and frailty criteria, account for dietary habits, and use specific nutritional assessment like Bioelectrical Impedance Analysis.
本研究旨在回顾关于口服营养补充剂（ONS）在老年癌症患者化疗期间作用的现有文献。检索电子数据库以查找截至2024年3月的相关研究。使用Cochrane工具评估纳入研究的偏倚风险。符合条件的研究包括评估ONS对老年（中位年龄>65岁）癌症患者化疗期间作用的随机、前瞻性和回顾性研究。提取有关化疗依从性、毒性、总生存期和营养状况的数据。共纳入10项研究，涉及1123名患者。由于结果的稀缺性和异质性，未对结果进行荟萃分析。一些ONS与化疗副作用发生率降低有关，尤其是口腔黏膜炎，并改善了营养状况。关于ONS对化疗依从性或总生存期的影响，证据有限或没有证据。研究了各种类型的ONS，包括采用定制营养咨询的多模式干预、乳清蛋白补充剂、氨基酸补充剂（包括免疫营养补充剂）和富含ω-3鱼油的补充剂。ONS在降低老年癌症患者化疗副作用和改善营养状况方面显示出前景，但需要进一步研究以探讨其对化疗依从性和总生存期的疗效。未来的研究应考虑年龄和衰弱标准，考虑饮食习惯，并使用生物电阻抗分析等特定营养评估方法。
