Dan Xin, He Ya-Lin, Tian Ya-Lin, Chen Tang-Lin, Yu Jia-Yi
Department of Radiation Therapy and Chemotherapy for Cancer Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China.
Cancer Med. 2024 Dec;13(24):e70519. doi: 10.1002/cam4.70519.
This paper aims to consolidate the most robust evidence on nutritional strategies for patients undergoing chemotherapy, offering evidence-based guidance for clinical practice. The review highlights critical evidence gaps in nutritional therapy for advanced gastric cancer (AGC) patients undergoing systemic therapy, integrating findings from both prospective and retrospective studies.
According to the "6S" evidence resource pyramid model, clinical decision-making tools, guidelines, expert consensus, and systematic reviews on nutritional management for chemotherapy patients were systematically retrieved from national and international databases. The methodological quality of the selected literature was evaluated using AGREE II for guidelines, the JBI Evidence-Based Healthcare Center's standards for systematic reviews, and expert consensus developed by evidence-based practice experts.
A total of 47 articles were analyzed, consisting of 12 guidelines, 12 expert consensus statements, and 23 systematic reviews. The findings were categorized into five dimensions: interdisciplinary collaboration, nutritional screening and assessment, nutritional requirements, nutritional therapy, and discharge and follow-up, resulting in the identification of 62 pieces of relevant evidence.
The study provides comprehensive, evidence-based recommendations for nutritional management in chemotherapy patients. Application of the evidence should be adapted to specific clinical scenarios, patient conditions, preferences, and expert judgment to ensure both feasibility and relevance in clinical practice.
This review consolidates diverse nutritional management strategies into a unified framework, addressing evidence gaps in AGC under systemic therapy. Integrating prospective and retrospective studies with interdisciplinary insights provides evidence-based recommendations to enhance patient care through personalized and standardized approaches.
本文旨在整合有关化疗患者营养策略的最有力证据，为临床实践提供循证指导。该综述突出了晚期胃癌（AGC）全身治疗患者营养治疗中关键的证据空白，综合了前瞻性和回顾性研究的结果。
根据“6S”证据资源金字塔模型，从国内外数据库中系统检索关于化疗患者营养管理的临床决策工具、指南、专家共识和系统评价。使用AGREE II对指南进行评估，采用循证卫生保健中心的系统评价标准以及循证实践专家制定的专家共识，对所选文献的方法学质量进行评价。
共分析了47篇文章，包括12篇指南、12篇专家共识声明和23篇系统评价。研究结果分为五个维度：跨学科协作、营养筛查与评估、营养需求、营养治疗以及出院与随访，共确定了62条相关证据。
该研究为化疗患者的营养管理提供了全面的循证建议。证据的应用应根据具体临床情况、患者状况、偏好和专家判断进行调整，以确保在临床实践中的可行性和相关性。
本综述将多种营养管理策略整合到一个统一框架中，解决了全身治疗下AGC的证据空白。将前瞻性和回顾性研究与跨学科见解相结合，通过个性化和标准化方法提供循证建议，以加强患者护理。
