Oral nutritional supplementation in cancer patients: A systematic review and dose–response meta-analysis

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition Pub Date : 2025-02-13 DOI:10.1016/j.clnu.2025.02.011

Sajedeh Habibi , Sepide Talebi , Darya Khosravinia , Hamed Mohammadi

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Abstract

Background & aims

We performed this systematic review and dose–response meta-analysis of randomized clinical trials (RCTs) to determine the effects of oral nutritional supplements (ONS) in cancer patients undergoing chemo (radio) therapy on body weight, body mass index (BMI), serum albumin, fatigue, quality of life (QOL), patient-generated subjective global assessment (PG-SGA) score and C-reactive protein (CRP).

Methods

Appropriate search terms were used for systematic search in PubMed, Scopus, and Web of Science, till April 2024. Both pairwise and dose–response meta-analyses were done. Random effects model was applied for analyses.

Results

We found that ONS administration significantly improved weight gain [weighted mean difference (WMD): 1.18 kg; 95 % CI, 0.20 to 2.17, P = 0.019; I² = 56.2 %, P_Q-test = 0.002], fatigue scores [standard mean difference (SMD): −1.45; 95 % CI, −2.48 to −0.42, P = 0.006; I² = 90.1 %, P_Q-test< 0.001], PG-SGA scores (WMD: −1.11; 95 % CI, −2.93 to 0.70, P = 0.229; I² = 72.4 %, P_Q-test = 0.001), and QOL (SMD: 1.38; 95 % CI, 0.45 to 2.31; P < 0.001; I² = 94.4 %, P_Q-test< 0.001). The dose–response meta-analysis found a significant relationship between each 200 ml/d increase in ONS and improvement in fatigue (SMD: −7.30; 95 % CI, −10.17 to −4.42, P < 0.001; I² = 97 %, P_Q-test< 0.001) and QOL scores (SMD:7.01; 95 % CI, 3.89 to 10.12, P = 0.001; I² = 98.3 %, P_Q-test < 0.001). Based on a non-linear dose–response meta-analysis, the most significant reduction in fatigue was observed at ONS dosages of ≥400 ml/day, while the most significant improvement in QOL score was seen at ≥ 500 ml/day dosages. Our analysis also showed a significant association between higher albumin levels and ONS intake of ≥200 ml daily.

Conclusions

In conclusion, ONS can help improve various cancer-related complications; however, further good-quality research is still needed. The study found that ONS significantly improves QoL, reduces fatigue, and promotes body weight gain in cancer patients. However, there were no significant effects on BMI, serum albumin, CRP, or PG-SGA scores.

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癌症患者的口服营养补充：一项系统评价和剂量反应荟萃分析

背景,目的：我们对随机临床试验（rct）进行了系统回顾和剂量反应荟萃分析，以确定口服营养补充剂（ONS）对接受化疗（放射）治疗的癌症患者的体重、体重指数（BMI）、血清白蛋白、疲劳、生活质量（QOL）、患者主观总体评估（PG-SGA）评分和c反应蛋白（CRP）的影响。方法选取合适的检索词，系统检索PubMed、Scopus和Web of Science，检索时间截止到2024年4月。进行了两两和剂量-反应荟萃分析。采用随机效应模型进行分析。结果我们发现给药后体重增加明显改善[加权平均差（WMD）： 1.18 kg；95% CI, 0.20 ~ 2.17, P = 0.019；I2 = 56.2%, PQ-test = 0.002]，疲劳评分[标准均差（SMD）：−1.45；95% CI,−2.48 ~−0.42,P = 0.006；I2 = 90.1%, PQ-test<；0.001]， PG-SGA评分(WMD:−1.11；95% CI,−2.93 ~ 0.70,P = 0.229；I2 = 72.4%, PQ-test = 0.001)和生命质量(SMD: 1.38;95% CI, 0.45 - 2.31；P & lt;0.001;I2 = 94.4%, PQ-test<；0.001)。剂量反应荟萃分析发现，ONS每增加200 ml/d与疲劳改善之间存在显著关系(SMD:−7.30；95% CI, - 10.17至- 4.42,P <；0.001;I2 = 97%, PQ-test<；0.001)和生活质量评分(SMD:7.01；95% CI, 3.89 ~ 10.12, P = 0.001；I2 = 98.3%, PQ-test <；0.001)。基于非线性剂量-反应荟萃分析，当ONS剂量≥400 ml/天时，观察到疲劳最显著的减轻，而≥500 ml/天剂量时，观察到生活质量评分最显著的改善。我们的分析还显示，较高的白蛋白水平与每日摄入≥200ml的ONS之间存在显著关联。结论：ONS可改善多种肿瘤相关并发症；然而，还需要进一步的高质量研究。研究发现，ONS显著改善了癌症患者的生活质量，减轻了疲劳，并促进了体重的增加。然而，对BMI、血清白蛋白、CRP或PG-SGA评分没有显著影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical nutrition 医学-营养学

CiteScore

14.10

自引率

6.30%

发文量

356

审稿时长

28 days

期刊介绍： Clinical Nutrition, the official journal of ESPEN, The European Society for Clinical Nutrition and Metabolism, is an international journal providing essential scientific information on nutritional and metabolic care and the relationship between nutrition and disease both in the setting of basic science and clinical practice. Published bi-monthly, each issue combines original articles and reviews providing an invaluable reference for any specialist concerned with these fields.