Zhang Juping, Kong Qian, Zhang Jibo, Guo Jun
Department of Oncology, Xingtai People's Hospital, Xingtai, 054000, China.
Department of Oncology, Xingtai People's Hospital, 818 Xiangdu North Road, Xingtai, 054000, China.
Open Med (Wars). 2024 Sep 4;19(1):20241023. doi: 10.1515/med-2024-1023. eCollection 2024.
Gastric cancer (GC) is a leading cause of cancer-related morbidity and mortality globally. This meta-analysis was conducted to assess the impact of nutritional interventions on clinical outcomes in GC patients.
Comprehensive search was conducted across four medical databases to identify randomized controlled trials (RCTs) that examined nutritional interventions in GC patients. The outcomes assessed included hospitalization duration, nutritional status, immune function, and complications.
A total of 11 studies were included. Enteral nutrition (EN) significantly reduce hospital stay duration compared to no nutritional intervention (SMD = -1.22, 95% CI [-1.72, -0.73], < 0.001) and parenteral nutrition (PN) (SMD = -1.30, 95% CI [-1.78, -0.82], < 0.001), but showed no significant difference compared to immunonutrition (IN). EN also improved nutritional status, indicated by higher albumin prealbumin levels, and improved immune function by elevating CD4+ levels (SMD = 1.09, 95% CI [0.61, 1.57], < 0.001). However, IN showed superior effects on immunoglobulin levels (IgG and IgM). No significant differences were observed in complication rates among EN, IN, and PN interventions.
Nutritional support, particularly EN and IN, can significantly improve hospitalization outcomes, nutritional status, and immune function. Customizing interventions according to patient requirements can optimize therapeutic outcomes, highlighting the need for further research in this area.
胃癌(GC)是全球癌症相关发病和死亡的主要原因。本荟萃分析旨在评估营养干预对GC患者临床结局的影响。
对四个医学数据库进行全面检索,以识别研究GC患者营养干预的随机对照试验(RCT)。评估的结局包括住院时间、营养状况、免疫功能和并发症。
共纳入11项研究。与无营养干预相比,肠内营养(EN)显著缩短住院时间(标准化均数差[SMD]=-1.22,95%置信区间[-1.72,-0.73],P<0.001),与肠外营养(PN)相比也显著缩短(SMD=-1.30,95%置信区间[-1.78,-0.82],P<0.001),但与免疫营养(IN)相比无显著差异。EN还改善了营养状况,表现为白蛋白和前白蛋白水平升高,并通过提高CD4+水平改善了免疫功能(SMD=1.09,95%置信区间[0.61,1.57],P<0.001)。然而,IN对免疫球蛋白水平(IgG和IgM)显示出更好的效果。在EN、IN和PN干预之间,并发症发生率未观察到显著差异。
营养支持,特别是EN和IN,可以显著改善住院结局、营养状况和免疫功能。根据患者需求定制干预措施可以优化治疗效果,突出了该领域进一步研究的必要性。