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非药物干预对鼻咽癌患者放化疗期间营养和免疫状况的影响:一项系统评价和荟萃分析方案

Effects of non-pharmacological interventions on nutrition and immune status of nasopharyngeal carcinoma patients during chemoradiotherapy: a systematic review and meta-analysis protocol.

作者信息

Xia Lijuan, Hayashi Naoko, Ota Erika, Qi Lin, Yan Bin

机构信息

Department of Radiotherapy, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China

Graduate School of Nursing Science, St. Luke's International University, Tokyo, Japan.

出版信息

BMJ Open. 2025 Sep 9;15(9):e103714. doi: 10.1136/bmjopen-2025-103714.

DOI:10.1136/bmjopen-2025-103714
PMID:40930546
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12421603/
Abstract

BACKGROUND

Nasopharyngeal carcinoma (NPC) presents significant nutritional challenges during concurrent chemoradiotherapy, adversely affecting treatment outcomes and quality of life. Non-pharmacological interventions may help improve nutritional and immune status, reduce complications and enhance overall well-being. However, evidence of their effectiveness is scattered and inconsistent, and no systematic review has yet synthesised the evidence on their effectiveness. This protocol outlines a systematic review and meta-analysis to evaluate the impact of non-pharmacological interventions on nutritional status, immune function and complications in NPC patients undergoing chemoradiotherapy. The findings may contribute to clinical recommendations and support evidence-based decision-making in the supportive care of NPC patients.

METHODS

This protocol follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. A comprehensive search will be conducted in MEDLINE, PubMed, CINAHL, EMBASE, Cochrane Library, Web of Science, ProQuest, China National Knowledge Infrastructure, Chinese Biomedical Literature Database and Wan Fang from November 2014 to November 2024. Search terms will include concepts related to NPC, nutrition, supplements, education, exercise, multimodal interventions and chemoradiotherapy. Only randomised controlled trials will be included. Two reviewers will independently screen studies, extract data and assess the risk of bias using the Cochrane Risk of Bias Tool V.2. Where appropriate, a meta-analysis will be performed using RevMan 5.4.

ETHICS AND DISSEMINATION

This systematic review does not directly involve the use of human beings; therefore, there is no requirement for ethical approval. Findings will be disseminated through peer-reviewed publications and in various media, such as conferences, congresses or symposia.

PROSPERO REGISTRATION NUMBER

CRD42024571769.

摘要

背景

鼻咽癌(NPC)在同步放化疗期间面临重大营养挑战,对治疗结果和生活质量产生不利影响。非药物干预可能有助于改善营养和免疫状况,减少并发症并提高整体幸福感。然而,其有效性的证据分散且不一致,尚无系统评价综合其有效性的证据。本方案概述了一项系统评价和荟萃分析,以评估非药物干预对接受放化疗的鼻咽癌患者营养状况、免疫功能和并发症的影响。研究结果可能有助于提出临床建议,并为鼻咽癌患者的支持性护理中的循证决策提供支持。

方法

本方案遵循系统评价和荟萃分析方案的首选报告项目指南。2014年11月至2024年11月,将在MEDLINE、PubMed、CINAHL、EMBASE、Cochrane图书馆、科学网、ProQuest、中国知网、中国生物医学文献数据库和万方进行全面检索。检索词将包括与鼻咽癌、营养、补充剂、教育、运动、多模式干预和放化疗相关的概念。仅纳入随机对照试验。两名评价员将独立筛选研究、提取数据并使用Cochrane偏倚风险工具V.2评估偏倚风险。在适当情况下,将使用RevMan 5.4进行荟萃分析。

伦理与传播

本系统评价不直接涉及人类使用;因此,无需伦理批准。研究结果将通过同行评审出版物以及各种媒体传播,如会议、大会或研讨会。

PROSPERO注册号:CRD42024571769。

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本文引用的文献

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Emerging Targets and Treatments for Sarcopenia: A Narrative Review.肌少症的新兴靶点和治疗方法:综述。
Nutrients. 2024 Sep 27;16(19):3271. doi: 10.3390/nu16193271.
2
Nutritional Status and Incidence of Radiation-Induced Oral Mucositis in Nasopharyngeal Carcinoma Patients Treated with Chemoradiotherapy.营养状况与放化疗治疗鼻咽癌患者放射性口腔黏膜炎的发生率。
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Nutritional status and its correlation to prognosis of nasopharyngeal carcinoma patients in different ages in China: a multicenter cohort study.
中国不同年龄段鼻咽癌患者的营养状况及其与预后的相关性:一项多中心队列研究。
Support Care Cancer. 2023 Oct 17;31(12):638. doi: 10.1007/s00520-023-08104-8.
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A Narrative Review of Non-Pharmacological Strategies for Managing Sarcopenia in Older Adults with Cardiovascular and Metabolic Diseases.老年心血管和代谢疾病患者肌肉减少症管理的非药物策略叙述性综述
Biology (Basel). 2023 Jun 21;12(7):892. doi: 10.3390/biology12070892.
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Impact of weight loss on treatment interruption and unplanned hospital admission in head and neck cancer patients undergoing curative (chemo)-radiotherapy in Hong Kong.香港头颈部癌症患者接受根治性(放化疗)期间体重减轻对治疗中断和非计划性住院的影响。
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Effects of induction chemotherapy on nutrition status in locally advanced nasopharyngeal carcinoma: a multicentre prospective study.诱导化疗对局部晚期鼻咽癌营养状况的影响:一项多中心前瞻性研究。
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PLoS One. 2022 Nov 28;17(11):e0278135. doi: 10.1371/journal.pone.0278135. eCollection 2022.
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Heterogeneity in pragmatic randomised trials: sources and management.实用随机临床试验中的异质性:来源与管理。
BMC Med. 2022 Oct 28;20(1):372. doi: 10.1186/s12916-022-02569-w.
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Radiother Oncol. 2022 May;170:122-128. doi: 10.1016/j.radonc.2022.03.009. Epub 2022 Mar 15.
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