Nutrition and Cancer-An International Journal最新文献

People living with and beyond cancer (LWBC) are advised to follow World Cancer Research Fund (WCRF) dietary guidelines. However, there is no established methodology to assess adherence. This study aimed to: (i) develop methodology to process dietary recalls into a format comparable to WCRF guidelines and (ii) evaluate the impact of additional data processing on estimates of dietary intake, in people LWBC. Advancing Survivorship Cancer Outcomes Trial (ASCOT) participants completed two 24-h dietary recalls at four timepoints using myfood24. Five WCRF recommendations (limiting consumption of energy dense foods, red meat and processed meat, and increasing consumption of fruit and vegetables and wholegrains and pulses) were operationalized (e.g. ≤ 500 g red meat per week). Quality control checks indicated the need for additional processing, including changing portion sizes and choosing alternative items from myfood24 to improve accuracy. Compared to myfood24 output, the processed dietary data indicated lower intake of fruit and vegetables, and higher intake of NSP and AOAC fiber (all ps < 0.001). Developing methodology to allow assessment of 24-h dietary recall data against WCRF guidelines was possible and necessary but resource intensive. Additional data processing impacted estimates of the key foods and nutrients consumed by trial participants in a meaningful way.

Obesity is a well-established risk factor for colorectal cancer (CRC) development, yet its influence on cancer-specific survival (CSS) and overall survival (OS) remains paradoxical. While obesity correlates with adverse outcomes such as increased recurrence, metastasis, and treatment-related complications, emerging evidence highlights a counterintuitive "obesity paradox," where overweight and moderately obese patients with Body Mass Index(BMI 25-30) exhibit improved CSS and OS compared to underweight (BMI <18.5) or morbidly obese (BMI >35) individuals. Proposed mechanisms for this paradox include altered molecular signaling (adipokine imbalances), enhanced energy metabolism, and greater treatment tolerance due to metabolic reserves. However, these findings are contentious, as BMI, a crude measure, fails to distinguish lean mass from visceral adiposity, key determinants of prognosis. Studies suggest that moderate obesity may buffer treatment toxicity, while extremes of BMI reflect frailty or metabolic dysfunction, worsening survival. This review critically examines the biological underpinnings of the obesity paradox and challenges BMI's reliability as a prognostic tool. Research must prioritize advanced body composition metrics (visceral fat quantification via imaging) to disentangle obesity's dual role in CRC outcomes. Such precision could guide tailored interventions, transforming the paradox from a scientific curiosity into a therapeutic strategy, optimizing survival for CRC patients across the weight spectrum.

Nutritional management has proven to be significant in the treatment of cancer. Nonetheless, studies have rarely conducted on outpatients with gastrointestinal stromal tumor (GIST) currently. Data of outpatients with GIST at our hospital from June 1, 2020, to August 1, 2022, were retrospectively analyzed. The Malnutrition Universal Screening Tool was used to screen outpatients with GIST for malnutrition risk, and malnutrition was identified using the Global Leadership Initiative on Malnutrition (GLIM) criteria. We hypothesized that malnutrition is associated with poor clinical outcomes in patients with GIST. This study included a total of 173 outpatients with GIST (82 males [47.4%] and 91 females [52.6%]; average age: 58.96 ± 10.53 years). Nutritional risk distribution was low in 60.12% (n = 104) of patients, moderate in 21.39% (n = 37), and high in 18.50% (n = 32). Malnutrition was diagnosed in 27.75% (n = 48) of patients. Multivariate analysis revealed that reduced food intake and low hemoglobin level were significant factors associated with malnutrition. Importantly, GLIM-defined malnutrition significantly affected progression-free survival (PFS) (hazard ratio [HR]: 3.702, 95% confidence interval (CI): 1.384-9.902, p = 0.005). Outpatients with GIST exhibit a high risk of malnutrition, and nutritional management may improve their prognosis. The GLIM criteria are effective for assessing malnutrition and predicting clinical outcomes in outpatients with GIST.

Background: Chemotherapy-induced anorexia and cachexia are significant challenges for patients with biliary tract cancer (BTC) and pancreatic ductal adenocarcinoma (PDAC). Megestrol acetate (MA), used to manage anorexia, has side effects and may trigger prescription cascades in cancer treatment. This study analyzed MA prescription trends and associated effects in BTC or PDAC patients.

Methods: MA prescription rates among BTC or PDAC patients were examined using data from the Health Insurance and Review Assessment Service database in Korea. We investigated thrombosis and anti-coagulant prescription rates during the same period.

Results: Analysis of 31,114 patients diagnosed with BTC or PDAC between 2009 and 2016 revealed significant increases in MA prescriptions: from 4.42% to 44.62% in BTC patients and from 7.56% to 63.15% in PDAC patients (p < 0.0001). In 2009, thrombosis was diagnosed in 5.58% of BTC patients and 6.83% of PDAC patients, rising to 7.62% and 12.47% by 2016. Anticoagulant prescriptions also increased, from 0.84% to 16.97% for BTC patients and from 2.37% to 15.96% for PDAC patients.

Conclusion: MA prescriptions for BTC or PDAC patients increased significantly over 8 years. Patients on long-term MA had higher anticoagulant prescription rates compared to those not on long-term MA.

Background: The global burden of digestive system tumors (e.g., hepatocellular carcinoma, gastric cancer, colorectal cancer) continues to rise, with low survival rates in advanced stages, necessitating etiology-based intervention strategies. Nutritional metabolic disorders are closely linked to tumor progression, but existing studies predominantly focus on correlational analyses, leaving causal relationships and molecular mechanisms poorly understood.

Objective: Integrating Mendelian randomization (MR), National Health and Nutrition Examination Survey (NHANES) epidemiological data, and transcriptomic data analysis, this study aims to elucidate the impact of nutritional status on digestive system tumors, identify key genes, develop prognostic models for precise nutritional interventions, and propose potential therapeutic directions.

Methods: Causal Inference: MR analysis using OpenGWAS data to assess causal associations between nutritional symptoms and digestive system tumor. Epidemiological Validation: Restricted cubic spline models analyzed nonlinear associations between nutritional status (Geriatric Nutritional Risk Index [GNRI]) and telomere length (DNAmTL) in NHANES 1999-2002 data (n = 2,532). Gender stratification and mediation effects tested nutritional pathways. Molecular Mechanism: Transcriptomic data from TCGA (CHOL, LIHC, COAD, etc.) identified malnutrition-related genes. Survival analysis, immune subtype classification (C1-C6), and tumor microenvironment scoring (ESTIMATE/RNAss) were integrated to build a Cox prognostic model. Machine learning (ML; Random Forest/Support Vector Machine) screened key genes. CellMiner database linked gene expression to drug sensitivity.

Results: Causal Association: MR confirmed significant causal effects of nutrition on digestive system tumor risk (P_IVW < 0.05). Gender Heterogeneity: Males exhibited accelerated telomere shortening at GNRI > 115 (β = -0.0123/unit, P = 0.035), while females showed no significant association. Dietary quality (Healthy Eating Index) directly protected telomeres (β = 0.069, P = 0.003), linked to seafood/plant protein (β = 0.066) and whole fruit intake (β = 0.067). Key Genes: ML identified ACTG2, MSX1, and COL7A1 as core drivers. Prognostic Model: A risk score model (ATP6V0A1*0.70 + TP63*0.37 + SLC7A7*0.49 + ARHGAP29*0.33 + CDH1*(-0.50)) distinguished high/low-risk groups (AUC = 0.977). Potentially Available Drugs: Zoledronate, LY-294002, and Everolimus may be potential choices for malnutrition digestive tract tumors.

Conclusion: This study systematically reveals multidimensional mechanisms linking malnutrition to digestive system tumor progression via genetic, molecular, and immune pathways. Key genes (ACTG2, MSX1, COL7A1) and gender-specific interventions offer novel strategies for precision on

Background: Children with acute lymphoblastic leukemia (ALL) have a higher risk of height deficit and obesity. Data on Chinese pediatric ALL patients treated on chemotherapy only are limited.

Methods: Changes in z scores for height and body mass index (BMI) from the diagnosis to 2 years after the initial of treatment were analyzed in 805 ALL patients diagnosed at Children's Hospital of Zhejiang University School of Medicine.

Results: A significant reduction in height z-scores and increase in BMI z-scores were documented during treatment (p < 0.001), the most pronounced changes observed in the first three months. Catch-up growth was noted after nine months. Children in middle-high-aged group showed the most significant decline in height z-scores after 24 months (p < 0.05). High-risk patients exhibited lower height z-scores at 9 and 12 months (p < 0.01). Children under 9 years or in non-high-risk group showed greater BMI z-scores increase during treatment (p < 0.05). There were no significant differences by gender.

Conclusion: Chemotherapy leads to height deficit and BMI increase in pediatric ALL patients. Height deficit is more pronounced in children aged 8-13 years, BMI increases are more significant in younger children. High-risk patients are more prone to lower height and smaller BMI increases.

The association between nutritional status and the risk of radiation pneumonitis (RP) in patients with thoracic cancer undergoing radiotherapy remains unclear and warrants further investigation. General clinical data between January 2021 and June 2024 were retrospectively analyzed. RP was diagnosed and graded according to the Common Terminology Criteria for Adverse Events (version 5), with symptomatic RP defined as grade ≥2. Predictive factors for RP were identified using least absolute shrinkage and selection operator and multivariate logistic regression analyses, followed by the development of a nomogram. The predictive performance of the nomogram was evaluated using the area under the curve (AUC) of receiver operating characteristic, calibration curve, and decision curve analysis. Controlling Nutritional Status (CONUT) scores and V₅ were identified as independent predictors of symptomatic RP and incorporated into the predictive model. The nomogram demonstrated excellent predictive capability (AUC: 0.851; 95% confidence interval: 0.801-0.902), with good accuracy and clinical application utility. Nutritional status is associated with the development of symptomatic RP. The pre-radiotherapy CONUT score can serve as a predictor of symptomatic RP, and its incorporation into the CONUT-V₅ model achieves better discriminative capacity. Improving nutritional status may be a simple way to prevent the development of symptomatic RP.

The purpose of the study is to determine if artificial intelligence (AI) models could provide dietary recommendations to manage chemotherapy-induced nutritional symptoms in breast cancer (BC) patients that are on comparable levels with the American Cancer Society, National Cancer Institute and World Cancer Research Fund guidelines which were used as evidence-based recommendation. The AI models-ChatGPT, ChatGPT 4.0, Gemini, Gemini Advanced, Copilot, and Copilot Pro-were evaluated based on their adherence to the guidelines. Specific queries were posed to each model, and the generated responses were rated by two experienced dietitians using a 5-point likert scale. Gemini provided the most adherent recommendations for metallic taste in mouth, while Gemini Advanced excelled in managing dehydration. ChatGPT and Gemini Advanced were the most effective in addressing heartburn, and Copilot Pro consistently showed the lowest performance across most symptoms. Overall, ChatGPT 4.0 attained the highest total score, followed by Copilot and Gemini, indicating a general trend where certain models were better suited for specific symptoms. Various AI models (e.g. ChatGPT 4.0) show potential in addressing certain chemotherapy-induced symptoms, but they do not consistently align with evidence-based recommendations. Improvement of AI models is necessary for their adherence to evidence-based recommendations.

Folate, a water-soluble B vitamin crucial for DNA synthesis and repair, is internalized by cells through specific folate receptors (FRs), which are frequently overexpressed in various types of cancers. In this comprehensive study, we conducted a review of the literature from Google Scholar, PubMed, and Science Direct, focusing on research published between 1980 and 2024 to evaluate folate-targeted therapeutic strategies in oncology. Our study design involved a rigorous review of both preclinical and clinical research, emphasizing strategies such as folate-drug conjugates, antibody-drug conjugates, and folate-targeted nanoparticles. Key findings indicate that targeting FRs in cancers such as ovarian, breast, cervical, renal, and colorectal enhances drug delivery specificity to tumors, increases therapeutic efficacy, and decreases systemic toxicity compared to traditional chemotherapy. Several clinical trials reported improved progression-free survival and overall response rates among patients receiving folate-targeted therapies. In conclusion, our review highlights the significant potential of folate-targeted strategies in advancing precision oncology while these approaches provide substantial benefits in terms of efficacy and safety, further research is essential to refine drug design and expand clinical applications. Such initiatives will facilitate the development of more personalized cancer treatment protocols that maximize therapeutic outcomes while minimizing adverse effects.