Effects of pediatric cancer and its treatment on nutritional status: A systematic review
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Date
2015-03-28Author
Revuelta-Iniesta, Raquel
Paciarotti, Ilenia
Brougham, F. H. M.
McKenzie, Jane
Wilson, D. C.
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Revuelta-Iniesta, R., Paciarotti, I., Brougham, M., McKenzie, J. & Wilson, D. (2015) Effects of pediatric cancer and its treatment on nutritional status: A systematic review. Nutrition Reviews, 73(5), pp. 276-295.
Abstract
Context: Malnutrition in pediatric cancer is common worldwide, yet its prevalence
and effects on clinical outcomes remain unclear.
Objective: The aim of this review was to evaluate primary research reporting the
prevalence of malnutrition in pediatric cancer patients and to assess the effects of
pediatric cancer and its treatment on nutritional status.
Data Sources: Electronic databases of MEDLINE, CINHAL, and PubMed were
searched (January 1990-February 2013).
Study Selection: Studies of patients aged <18 years who were diagnosed with
and treated for cancer and for whom measurements of anthropometry were reported
were included. The primary outcome was the prevalence of malnutrition
(undernutrition and overnutrition), expressed as body mass index (BMI), in children
diagnosed with and treated for cancer.
Data Extraction: Evidence was appraised critically by employing the Critical
Appraisal Skills Program tool, and data was extracted from original articles.
Data Synthesis: A total of 46 studies were included, most of which were considered
to be of low quality on the basis of heterogeneity in both the criteria and the
measurements used to define malnutrition. Undernutrition was identified by
measuring BMI, weight loss, mid-upper arm circumference, and triceps skinfold
thickness, while overnutrition was assessed using BMI. Overall, the prevalence of
undernutrition ranged from 0% to 65% and overnutrition from 8% to 78%. Finally,
undernutrition in pediatric cancer at diagnosis was associated with poor clinical
outcomes in 6 of 9 studies.
Conclusion: The possibility of a high prevalence of malnutrition in childhood cancer,
indicated by the studies reviewed, highlights the need for high-quality, populationbased,
longitudinal studies using standard criteria to identify malnutrition.