Dietary Counseling Interventions During Radiation Therapy: A Systematic Review of Feasibility, Safety, and Efficacy.

IF 2 4区 医学 Q3 NUTRITION & DIETETICS Nutrition and Cancer-An International Journal Pub Date : 2024-09-28 DOI:10.1080/01635581.2024.2406999
Alexie Oppermann, Shalet James, Mackenzie M Minotti, Kaitlin M Schotz, Martha E Francis, Ian R Kleckner, Melissa A L Vyfhuis, Matthew J Ferris, Brenton J Baguley, Amber S Kleckner
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Abstract

Radiotherapy is a common cancer treatment, and concurrent nutritional interventions can maintain nutritional status and improve clinical and supportive care outcomes. However, optimal nutritional interventions during radiotherapy are not firmly established. Herein, we assessed the feasibility, safety, and efficacy of dietary counseling interventions without oral nutrition supplements on health outcomes in adults receiving radiotherapy for cancer in a systematic review. Prospective clinical trials that implemented nutritional counseling interventions during radiotherapy were identified from four databases from inception through December 2023. Feasibility, safety, and efficacy were extracted from 32 articles that described 23 randomized and 4 non-randomized clinical trials. The interventions included individualized nutritional counseling (n = 14 articles), nutritional counseling plus exercise (n = 4), and nutritional counseling focused on increasing or reducing intake of specific nutrients (n = 9). Trials targeted head and neck (n = 12), pelvic cancers (n = 14), and/or breast (n = 5) cancers. Control groups had variable designs and included general nutrition education and intervention as needed. Studies recruited 120 ± 104 participants (range 26-468). Interventions tended to be feasible regarding retention and attendance at sessions, though feasibility metrics varied among different interventions. Most interventions were safe with no studies reporting adverse events attributable to dietary intervention. Individualized dietary counseling interventions tended to lead to between-group differences favoring the intervention group in regard to improved nutritional status, maintenance or attenuation of loss of body mass, improved quality of life, and reduced radiation-induced toxicities. Diets that encouraged/discouraged specific nutrients tended to recruit patients receiving radiation to the pelvic area and resulted in positive or neutral effects on gastrointestinal symptoms. In conclusion, nutritional interventions appear to be feasible, safe, and effective during radiotherapy for various symptom outcomes.

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放射治疗期间的饮食咨询干预:关于可行性、安全性和有效性的系统回顾。
放疗是一种常见的癌症治疗方法,同时进行营养干预可以维持营养状况,改善临床和支持性护理效果。然而,放疗期间的最佳营养干预措施尚未得到牢固确立。在此,我们通过一项系统性综述评估了在不使用口服营养补充剂的情况下,膳食咨询干预对接受癌症放疗的成人健康结果的可行性、安全性和有效性。我们从四个数据库中找到了在放疗期间实施营养咨询干预的前瞻性临床试验,试验时间从开始到 2023 年 12 月。从 32 篇文章中提取了可行性、安全性和有效性,这些文章描述了 23 项随机临床试验和 4 项非随机临床试验。干预措施包括个体化营养咨询(14 篇文章)、营养咨询加运动(4 篇文章)以及侧重于增加或减少特定营养素摄入量的营养咨询(9 篇文章)。试验针对头颈部癌症(12 项)、盆腔癌症(14 项)和/或乳腺癌(5 项)。对照组的设计各不相同,包括一般营养教育和必要的干预。研究招募了 120 ± 104 名参与者(范围为 26-468)。尽管不同干预措施的可行性指标各不相同,但干预措施在保留率和出席率方面往往是可行的。大多数干预措施都是安全的,没有研究报告称饮食干预会导致不良事件。在改善营养状况、维持或减轻体重下降、提高生活质量和减少辐射引起的毒性方面,个性化饮食咨询干预往往会产生有利于干预组的组间差异。鼓励/不鼓励摄入特定营养素的饮食往往会吸引盆腔区域接受放射治疗的患者,并对胃肠道症状产生积极或中性的影响。总之,在放疗期间进行营养干预似乎是可行、安全和有效的,可改善各种症状。
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
CiteScore
5.80
自引率
3.40%
发文量
172
审稿时长
3 months
期刊介绍: This timely publication reports and reviews current findings on the effects of nutrition on the etiology, therapy, and prevention of cancer. Etiological issues include clinical and experimental research in nutrition, carcinogenesis, epidemiology, biochemistry, and molecular biology. Coverage of therapy focuses on research in clinical nutrition and oncology, dietetics, and bioengineering. Prevention approaches include public health recommendations, preventative medicine, behavior modification, education, functional foods, and agricultural and food production policies.
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