Clinical implications of malnutrition in children with cancer

Barr, Ronald D.

doi:10.1007/s00520-015-2681-1

Cited by 3 publications

(3 citation statements)

References 4 publications

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“…In his letter, Barr states that the plea in our article-to undertake larger prospective case-control studies to further investigate the role of malnutrition in childhood cancer-has been preempted and acted upon already [2]. However, we cannot agree with this statement, for reasons stated below.…”

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confidence: 40%

Clinical implications of malnutrition in children with cancer

Loeffen

Brinksma

Tissing

2015

Support Care Cancer

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To the editor,We thank Barr for the interest in our recent research article regarding the clinical implications of malnutrition in childhood cancer patients [1]. In his letter, Barr states that the plea in our article-to undertake larger prospective case-control studies to further investigate the role of malnutrition in childhood cancer-has been preempted and acted upon already [2]. However, we cannot agree with this statement, for reasons stated below. Also, in our opinion, Barr's points of critic do not touch the fundaments of our study, among other things correcting for the variety of diseases and corresponding prognoses, and therefore do not decrease the scientific value of our findings and conclusions.The study Barr is referring to from Sala et al. is a very nice study which indeed included far more patients than we did [3]. We agree with Barr that the reference to this study is not accompanied by the correct text, for which we apologize. Also, in retrospect, it would have strengthened our paper to discuss the results from the study of Sala et al. in more detail and compare these with our results. Also, incorporation of results of the study of Antillon et al., as suggested by Barr in his letter, would have been a valuable addition [4].However, focusing on the results of Sala et al., there are two vital differences between our study and Sala's study, apart from the previously mentioned difference in sample size. First, economical differences and corresponding health care situation. The referred study by Sala et al. was performed in Costa Rica, Dominican Republic, El Salvador, Guatemala, Honduras, Nicaragua, and Panama. All these countries are categorized as developing counties (gross national income per capita lower than $12,746) by the World Bank [5]. Our study was performed in the Netherlands, which is categorized as a developed country. Large differences between developed and developing countries exist in prevalence of malnutrition, which for example is shown in prevalence of severe malnutrition in the mentioned studies; 17.1 % in the study of Sala et al. versus 5.2 % in our study. However, it should be noted that different cutoff points and reference values for malnutrition hinder a one-to-one comparison of our results. Geographical differences in our studies are not limited to malnutrition alone, as prognosis of childhood cancer also differs substantially, with a 3-year overall survival of 48 % in Central America and Caribbean countries (where the study of Sala et al. took place) versus a 3-year overall survival of 81 % in Central Europe (where our study took place) [6,7]. In our opinion, the previously mentioned differences make it impossible to compare these studies.Second, although Sala et al. did include an unselected variety of cancers in their study, they have not attempted to correct for this variety. As there are many different cancer types, prognosis and severity of treatment can vary greatly. We corrected for expected prognosis based on diagnosis and intensity of treatment in our analyses. Ther...

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confidence: 40%

Clinical implications of malnutrition in children with cancer

Loeffen

Brinksma

Tissing

2015

Support Care Cancer

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“…Such conditions can increase treatment-related morbidities and mortality, as well as health care costs and abandonment of therapy. [4][5][6][7][8][9] Moreover, studies in children with acute lymphoblastic leukemia (ALL) have demonstrated that the remediation of compromised nutritional status during treatment can improve survival, which supports the hypothesis that nutritional status is a modifiable risk factor for adverse outcomes. 10,11 However, there is a significant gap in the literature regarding high-quality research on the relationship between nutrition and cancer in children in LMICs, including in Brazil, which creates obstacles to determining the optimal standards of nutritional care for this patient population and remains a barrier to setting educational and research priorities, thereby preventing the field from advancing.…”

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confidence: 93%

Nutrition of Children With Cancer in Brazil: A Systematic Review

Viani

Albuquerque

Barr

et al. 2020

JCO Global Oncology

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PURPOSE The objective of this systematic review was to describe nutrition-related publications on children and adolescents diagnosed with cancer in Brazil. METHODS The methodology followed that of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Medline, LILACS (the Latin American & Caribbean Health Sciences Literature), and Embase were searched in April 2019, and data extraction and rating of methodologic study quality (according to the National Institutes of Health quality score assessment) were performed independently by reviewers. RESULTS Twenty-seven studies met the inclusion criteria, reporting on 3,509 patients from 1994 to 2018. Most of the studies (74%) were of poor quality in methodology and reporting. Different cancer diagnoses were included in 52% of studies, whereas acute leukemia was the exclusive focus in 41%. The majority of the articles (70%) were from institutions in the Southeast Region of Brazil, mainly the state of São Paulo (74%); no publications were from the North Region of the country. Twelve studies addressed nutritional status and body composition, reporting an abundance of malnourished patients in the Brazilian population of children and adolescents with cancer. Six studies on micronutrients pointed to possible deficiencies in this population, with a yet unclear but promising role for supplementation during treatment. CONCLUSION Evidence indicates that there is great interest in the impact of nutrition on childhood cancer treatment and clinical outcomes in Brazil. However, there is a need to focus on high-quality research, particularly with multicentric/national studies. This will help establish research priorities and better planned clinical interventions, adapted to each region of the country.

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“…24,25 O estado nutricional adequado durante o tratamento antineoplásico é essencial na redução do risco de infecções, menor morbidade, toxicidade, tempo de internação, abandono de tratamento, custo hospitalar e, consequentemente, melhor sobrevida e melhora geral da qualidade de vida. 22,[24][25][26][27][28][29][30][31][32] barato e não invasivo. 20,29,33,35,36 Diretrizes previamente publicadas pela sociedade internacional de oncologia pediátrica (SIOP) recomendam a CB para medir o estado nutricional de crianças com câncer, uma vez que a medida não é afetada pela massa tumoral e por ser bem estabelecida na literatura para tal fim.…”

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Estado nutricional e sobrevida global de crianças e adolescentes com câncer acompanhados pelo serviço de nutrição

Viani¹

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Clinical implications of malnutrition in children with cancer

Cited by 3 publications

References 4 publications

Clinical implications of malnutrition in children with cancer

Clinical implications of malnutrition in children with cancer

Nutrition of Children With Cancer in Brazil: A Systematic Review

Estado nutricional e sobrevida global de crianças e adolescentes com câncer acompanhados pelo serviço de nutrição

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