Management of Nutritional Needs in Pediatric Oncology: A Consensus Statement

Fabozzi, Francesco; Trovato, Chiara Maria; Diamanti, Antonella; Mastronuzzi, Angela; Zecca, Marco; Tripodi, Serena Ilaria; Masetti, Riccardo; Leardini, Davide; Muratore, Edoardo; Barat, Veronica; Lezo, Antonella; Lorenzo, Francesco De; Caccialanza, Riccardo; Pedrazzoli, Paolo

doi:10.3390/cancers14143378

Cited by 33 publications

(38 citation statements)

References 63 publications

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“…Apart from the direct effect of cancer itself on nutritional status, several factors can also affect both appetite and food intake among cancer patients. Such factors include some common complications of cancer treatment, such as nausea, vomiting, mucositis (oral, esophageal, and bowel), diarrhea, and/or constipation [ 61 ]. Thus, targeted interventions to improve the nutritional status of children with cancer remain challenging.…”

Section: Discussionmentioning

confidence: 99%

Nutritional Status at Diagnosis as Predictor of Survival from Childhood Cancer: A Review of the Literature

et al. 2022

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Few studies so far have examined the impact of nutritional status on the survival of children with cancer, with the majority of them focusing on hematological malignancies. We summarized published evidence reporting the association of nutritional status at diagnosis with overall survival (OS), event-free survival (EFS), relapse, and treatment-related toxicity (TRT) in children with cancer. Published studies on children with leukemia, lymphoma, and other solid tumors have shown that both under-nourished and over-nourished children at cancer diagnosis had worse OS and EFS. Particularly, the risk of death and relapse increased by 30–50% among children with leukemia with increased body mass index at diagnosis. Likewise, the risk of TRT was higher among malnourished children with osteosarcoma and Ewing sarcoma. Nutritional status seems to play a crucial role in clinical outcomes of children with cancer, thus providing a significant modifiable prognostic tool in childhood cancer management. Future studies with adequate power and longitudinal design are needed to further evaluate the association of nutritional status with childhood cancer outcomes using a more standardized definition to measure nutritional status in this population. The use of new technologies is expected to shed further light on this understudied area and give room to person-targeted intervention strategies.

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Section: Discussionmentioning

confidence: 99%

Nutritional Status at Diagnosis as Predictor of Survival from Childhood Cancer: A Review of the Literature

et al. 2022

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“…Nutritional assessment should consider the NS of the patient, GI function, intensity of treatment and current or expected side effects of treatment. A recent consensus statement, performed by Fabozzi et al, proposed a timing of nutritional assessment during pediatric cancer treatment [ 29 ]. Children receiving intensive treatment or at high risk of malnutrition should be evaluated at a maximum interval of 3–4 weeks.…”

Section: Methods To Analyze Nutritional Status In Children With Cancermentioning

confidence: 99%

“…Undernourished children require monthly assessment until they achieve normal NS. Obese children need revaluation every 3 months [ 29 , 31 ]. Table 3 summarizes the proposed timing of nutritional assessment into survivorship.…”

Section: Methods To Analyze Nutritional Status In Children With Cancermentioning

confidence: 99%

Role of Nutrition in Pediatric Patients with Cancer

et al. 2023

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Children with cancer are at high risk for developing short-term and long-term nutritional problems related to their underlying disease and side effects of multimodal treatments. Nutritional status (NS) can influence several clinical outcomes, such as overall survival (OS) and event-free survival (EFS), treatment tolerance, risk of developing infections and quality of life (QoL). However, the importance of nutrition in children with cancer is still underestimated. This review focuses on alterations of NS that occurs in children during cancer treatment. In particular, we reviewed the pathogenesis of undernutrition in oncological children, as well as how NS affects treatment tolerance and response, the immune system and the risk of infections of children with cancer. Thanks to recent advances in all types of supportive therapy and to the progress of knowledge on this topic, it has been realized that NS is a modifiable prognostic factor that can be intervened upon to improve the outcome of these patients. Currently, there is a lack of a systematic approach and standard recommendations for nutritional care in the pediatric cancer population. Literature analysis showed that it is essential to define the NS and treat any alterations in a timely manner ensuring proper growth and development. Nutritional follow-up should become an integral part of the care pathway. Regular nutritional monitoring should be performed at diagnosis, during treatment and during follow-up. A close collaboration and sharing of expertise between pediatric oncologists and nutrition specialists, combined with careful and participatory sharing of the feeding experience with the family and the child (after age 6 years), is strongly required.

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“…11 This study focuses on the need of early detection and intervention to prevent nutritional deterioration and thus lessen the burden of cancer morbidity and mortality in the pediatric population. 17,18 Since it is a single centered study, the results cannot be generalized.…”

Section: R E S U L T Smentioning

confidence: 99%

C -Reactive Protein, Leukocyte Count and Neutrophils: A Diagnostic Aid in Acute Appendicitis

Shaheen

Yasmeen²,

Manzoor

et al. 2023

J Islamabad Med Dental Coll

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Background: Malnutrition is known to be a poor prognostic factor affecting the outcome of pediatric cancers. The objective of this study was to assess the pre-existing malnutrition in newly diagnosed pediatric cancer patients presenting at the Pediatric Oncology Department, Children Hospital, PIMS and their number of hospital admissions due to causes other than chemotherapy. Methodology: Data of 44 newly diagnosed children with cancer was analyzed to find out the association of nutritional status according to z-score for weight and height for age, body mass index (BMI) and mid-upper arm circumference (MUAC) with their number of hospital admissions for 6 months since their date of diagnosis. Results: The mean age of the study subjects was 4.25 ± 2.85 years, out of which 33(75%) were males and 11(25%) females. Most of the patients were diagnosed with leukemia or lymphoma. Nutritional status evaluation of thirty patients who got admitted was mild to moderate wasting in 24(80%) assessed by weight for age, mild to moderate stunting in 21 (70%) according to height for age and mild to severe malnutrition in 10 (33%) based on body mass index and mid upper arm circumference (MUAC). There was significant association between nutritional status of patients at the time of diagnosis with additional hospitalization with p value less than 0.05 Conclusion: Malnutrition at the time of diagnosis is significantly associated with an increase in the number of hospital admissions in pediatric cancer patients. Key words: Hospitalization, Malnutrition, Oncology, Pediatric

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Management of Nutritional Needs in Pediatric Oncology: A Consensus Statement

Cited by 33 publications

References 63 publications

Nutritional Status at Diagnosis as Predictor of Survival from Childhood Cancer: A Review of the Literature

Nutritional Status at Diagnosis as Predictor of Survival from Childhood Cancer: A Review of the Literature

Role of Nutrition in Pediatric Patients with Cancer

C -Reactive Protein, Leukocyte Count and Neutrophils: A Diagnostic Aid in Acute Appendicitis

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