首頁資訊 Nutritional counseling for patients with incurable cancer: Systematic review and meta

Nutritional counseling for patients with incurable cancer: Systematic review and meta

來源：泰然健康網(wǎng) 時間：2025年08月20日 15:23

Background & aims

This systematic review aims to determine whether nutritional counseling by registered dietitians and/or nutritional specialists is recommended for adult patients with incurable advanced or recurrent cancer who are refractory to or intolerant of anticancer therapy.

Methods

This systematic review analyzed randomized controlled trials (RCTs) of nutritional counseling in cancer patients older than 18 years, primarily those with stage 4 cancer. Nutrition counseling was performed by registered dietitians and/or nutritional specialists using any method, including group sessions, telephone consultations, written materials, and web-based approaches. We searched the Medline (PubMed), Medline (OVID), EMBASE (OVID), CENTRAL, Emcare, and Web of Science Core Collection databases for articles published from 1981 to 2020. Two independent authors assessed the risk of bias used the Cochrane Risk of Bias 2 tool. Meta-analysis was performed for results and outcomes that allowed quantitative integration. This systematic review protocol was registered with the International Prospective Register of Systematic Reviews (ID: CRD42021288476) and registered in 2021.

Results

The search yielded 2376 studies, of which 7 assessed 924 patients with cancer aged 24–95 years. Our primary outcome of quality of life (QoL) was reported in 6 studies, 2 of which showed improvement with nutritional counseling. Our other primary outcome of physical symptoms was reported in two studies, one of which showed improvement with nutritional counseling. Quantitative integration of both QoL and physical symptoms was difficult. A meta-analysis of energy and protein intake and body weight was performed for secondary outcomes. Results showed that nutrition counseling increased energy and protein intake, but total certainty of evidence (CE) was low. Bodyweight was not improved by nutrition counseling.

Conclusions

Nutrition counseling is shown to improve energy and protein intake in patients with incurable cancer. Although neither nutrient intake can be strongly recommended because of low CE, nutrition counseling is a noninvasive treatment strategy that should be introduced early for nutrition intervention for patients with cancer. This review did not find sufficient evidence for the effect of nutrition counseling on QoL, a patient-reported outcome. Overall, low-quality and limited evidence was identified regarding the impact of nutrition counseling for patients with cancer, and further research is needed.

中文翻譯：

無法治愈的癌癥患者的營養(yǎng)咨詢：系統(tǒng)評價和薈萃分析

背景與目標(biāo)

本系統(tǒng)評價旨在確定注冊營養(yǎng)師和/或營養(yǎng)專家的營養(yǎng)咨詢是否推薦用于抗癌治療難治或不耐受的無法治愈的晚期或復(fù)發(fā)性癌癥成年患者。

方法

該系統(tǒng)評價分析了針對 18 歲以上癌癥患者（主要是 4 期癌癥患者）進(jìn)行營養(yǎng)咨詢的隨機(jī)對照試驗 (RCT)。營養(yǎng)咨詢由注冊營養(yǎng)師和/或營養(yǎng)專家使用任何方法進(jìn)行，包括小組會議、電話咨詢、書面材料和基于網(wǎng)絡(luò)的方法。我們在 Medline (PubMed)、Medline (OVID)、EMBASE (OVID)、CENTRAL、Emcare 和 Web of Science 核心合集數(shù)據(jù)庫中搜索了 1981 年至 2020 年發(fā)表的文章。兩位獨立作者使用 Cochrane 風(fēng)險評估偏倚風(fēng)險偏差 2 工具。對允許定量整合的結(jié)果和結(jié)果進(jìn)行了薈萃分析。該系統(tǒng)評價方案已在國際前瞻性系統(tǒng)評價登記冊（ID：

結(jié)果

檢索產(chǎn)生了 2376 項研究，其中 7 項研究評估了 924 名年齡在 24-95 歲之間的癌癥患者。我們在 6 項研究中報告了我們的主要生活質(zhì)量 (QoL) 結(jié)果，其中 2 項顯示營養(yǎng)咨詢有所改善。我們在兩項研究中報告了身體癥狀的其他主要結(jié)果，其中一項顯示營養(yǎng)咨詢有所改善。QoL 和身體癥狀的定量整合很困難。對次要結(jié)果進(jìn)行了能量和蛋白質(zhì)攝入以及體重的薈萃分析。結(jié)果表明，營養(yǎng)咨詢增加了能量和蛋白質(zhì)的攝入量，但總體證據(jù)質(zhì)量 (CE) 較低。營養(yǎng)咨詢并未改善體重。

結(jié)論

營養(yǎng)咨詢被證明可以改善無法治愈的癌癥患者的能量和蛋白質(zhì)攝入量。雖然由于 CE 低而不能強(qiáng)烈推薦營養(yǎng)攝入，但營養(yǎng)咨詢是一種非侵入性治療策略，應(yīng)及早引入癌癥患者的營養(yǎng)干預(yù)。該評價沒有找到足夠的證據(jù)證明營養(yǎng)咨詢對 QoL 的影響，QoL 是患者報告的結(jié)果?？傮w而言，關(guān)于營養(yǎng)咨詢對癌癥患者影響的證據(jù)質(zhì)量低且有限，需要進(jìn)一步研究。