Reviews: Special Nutritional Needs of Children with Malignancies: A Review

Abstract

Nutrition support for the patient with cancer is an important part of the overall treatment regimen. Nutrition support for the child with cancer poses a special challenge. For the purpose of reviewing the special nutritional needs of children with cancer, a Task Force was formed by the American Academy of Pediatrics to review the current state of knowledge. The work of the Task Force was supported by the Food and Drug Administration through its Liaison Representative, Joginder Chopra, M.D., Staff support from the Academy was provided by Jean D. Lockhart, M.D., This review is prepared from the Task Force Report to the FDA. It is designed to review factors enhancing nutritional risks for the child with cancer and to discuss nutritional intervention strategies and their efficacies.

Effects of naso-gastric tube feeding on the nutritional status of children with cancer

“…Furthermore, a poor nutritional status has been associated with an impaired tumour response to treatment and outcome of disease (Donaldson et al, 1981;van Eys, 1982;Rickard et al, 1983a), reduced therapy tolerance van Eys, 1979;Filler et al, 1977;Hays et al, 1983;Rickard et al, 1983aRickard et al, , 1985, impaired immunological function (van Eys, 1979;van Eys et al, 1980) and a reduced state of well-being and performance (Donaldson et al, 1981;van Eys, 1979;Mauer et al, 1990). The aim of nutritional intervention must therefore be the prevention of therapy-related malnutrition and the added effects of protein energy malnutrition (PEM).…”

Prevalência de desnutrição em crianças com tumores sólidos

“…Tais fatores têm papel importante na etiologia da desnutrição dos pacientes com câncer, e incluem a redução da ingestão alimentar, assim como as alterações no gasto energético e na absorção e metabolismo de nutrientes, além de outras complicações, como toxicidade oral e gastrintestinal, nefrotoxicidade e infecções 3 .…”

“…As modalidades terapêuticas mais agressivas, como grandes procedimentos cirúrgicos, a freqüência dos ciclos de quimioterapia e a radioterapia de grandes áreas, provocam o desenvolvimento da DEP 3 , pois além de complicações, tais como dor, febre, infecções freqüentes ou graves, causam a redução do apetite e aumentam o requerimento energético, agravando o estado de desnutrição 4 .…”

“…Analisando as possíveis causas para o elevado percentual de desnutrição neste grupo de estudo, podemos levantar algumas hipóteses. Além da própria doença, que por si só aumenta o gasto de energia, consome os nutrientes do hospedeiro, aumentando seu catabolismo e prejudicando o metabolismo e aproveitamento normal dos nutrientes, o tratamento tem um impacto extremamente agressivo para o organismo 3 . Estes fatores são inerentes à doença e à terapia antineoplásica e, portanto, relativamente comuns entre os pacientes com câncer.…”

Role of pharmacists in optimizing the use of anticancer drugs in the clinical setting

“…83 Weight loss may be a diagnostic factor in certain cancers, and cachexia is a hallmark of cancer patients, exhibited by early satiety, weight loss, and asthenia. 28,[84][85][86] Poor nutrition can impact the patient's ability to tolerate recommended doses of chemotherapy and ability to recover from chemotherapy side effects. It is essential for the health care team to utilize the OPS to maximize the nutrition status of the patient in order for optimum antineoplastic dose administration.…”