Effectiveness of nutritional support for clinical outcomes in gastric cancer patients: A meta-analysis of randomized controlled trials.

IF 1.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Open Medicine Pub Date : 2024-09-04 eCollection Date: 2024-01-01 DOI:10.1515/med-2024-1023
Juping Zhang, Qian Kong, Jibo Zhang, Jun Guo
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Abstract

Background: 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.

Methods: 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.

Results: 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], P < 0.001) and parenteral nutrition (PN) (SMD = -1.30, 95% CI [-1.78, -0.82], P < 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], P < 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.

Conclusion: 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.

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营养支持对胃癌患者临床疗效的影响:随机对照试验荟萃分析。
背景:胃癌(GC)是全球癌症相关发病率和死亡率的主要原因。本荟萃分析旨在评估营养干预对胃癌患者临床疗效的影响:在四个医学数据库中进行了全面搜索,以确定对胃癌患者进行营养干预的随机对照试验(RCT)。评估的结果包括住院时间、营养状况、免疫功能和并发症:结果:共纳入 11 项研究。与无营养干预(SMD = -1.22, 95% CI [-1.72, -0.73],P < 0.001)和肠外营养(PN)(SMD = -1.30, 95% CI [-1.78, -0.82],P < 0.001)相比,肠内营养(EN)可明显缩短住院时间,但与免疫营养(IN)相比无明显差异。免疫营养也改善了营养状况(表现为白蛋白前白蛋白水平升高),并通过提高 CD4+ 水平改善了免疫功能(SMD = 1.09,95% CI [0.61,1.57],P <0.001)。不过,IN 对免疫球蛋白水平(IgG 和 IgM)的影响更大。在并发症发生率方面,EN、IN 和 PN 干预措施之间未发现明显差异:营养支持,尤其是 EN 和 IN,可显著改善住院效果、营养状况和免疫功能。根据患者需求定制干预措施可优化治疗效果,这也凸显了在该领域开展进一步研究的必要性。
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来源期刊
Open Medicine
Open Medicine Medicine-General Medicine
CiteScore
3.00
自引率
0.00%
发文量
153
审稿时长
20 weeks
期刊介绍: Open Medicine is an open access journal that provides users with free, instant, and continued access to all content worldwide. The primary goal of the journal has always been a focus on maintaining the high quality of its published content. Its mission is to facilitate the exchange of ideas between medical science researchers from different countries. Papers connected to all fields of medicine and public health are welcomed. Open Medicine accepts submissions of research articles, reviews, case reports, letters to editor and book reviews.
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