Quality of Life of Cancer Patients Receiving Enteral Nutrition: A Systematic Review of Randomized Controlled Trials

Abstract

Most studies confirm the beneficial effects of enteral nutrition on the quality of life, but some studies indicate an inverse association and its detrimental impacts. However, there are insufficient data on the effects of enteral nutrition on the quality of life of cancer patients. This systematic review aimed to describe the influence of applied enteral nutrition on the quality of life of cancer patients, based on the results of randomized controlled trials. It was registered in the PROSPERO database (CRD42021261226) and conducted based on the PRISMA guidelines. The searching procedure was conducted using the PubMed and Web of Science databases, as well as Cochrane Library, and it included studies published until June 2021. It was conducted to select randomized controlled trials assessing the influence of enteral nutrition (compared with the other model of nutrition) on the quality of life of cancer patients. A general number of 761 records were screened and a final number of 16 studies were included in the systematic review. The studies were included and assessed by two independent researchers, while the risk of bias was analyzed using the Newcastle–Ottawa Scale (NOS). Studies compared patients treated with and without enteral nutrition, patients treated with various methods of enteral nutrition or with enteral diets of various content, as well as patients treated with enteral and parenteral nutrition. Within the included studies, the majority were conducted in patients with cancers located in various parts of the body, or diverse areas within the gastrointestinal system, while some studies were conducted in specific populations of patients with a defined cancer location—esophagus, stomach, or ovary. The duration of applied enteral nutrition within the included studies was diversified—from two weeks or less to half a year or even more. The vast majority of studies used well-known and validated tools to assess the quality of life, either developed for a specific group of head/neck, esophagus/stomach, and ovary cancer patients or developed for more general patient populations. Most studies concerning patients treated with and without enteral nutrition supported applying enteral nutrition, which was concluded in seven studies out of ten (including four studies with a low risk of bias). The other important observations to be emphasized—formulated based on the studies with a low risk of bias—presented the role of oral supportive nutrition guided by a dietitian, as well as the beneficial role of enteral and parenteral nutrition, combined. In spite of a relatively low number of randomized controlled trials assessing the influence of enteral nutrition on the quality of life of cancer patients, which should be considered as a limitation, the results were promising. Most studies supported the positive influence of enteral nutrition on the quality of life, either assessed based on the psychological measures of the quality of life or by considering the other potential determinants (e.g., malnutrition, complications, etc.). Taking this into account, enteral nutrition should be applied whenever possible, both to prevent and treat malnutrition in cancer patients. However, considering the limited number of studies conducted so far, further research conducted in homogenic populations of patients is necessary.

Dietary intake effects on severity of cancer treatment‐induced mucositis: A cross‐sectional study

“…Results showed that glutamine could significantly eliminate the maximal mucositis grade and pain score at Weeks 4, 5, and 6. 15 However, these results are somewhat in conflict with the results of the study done by Gliwska et al, 16 which determine whether glutamine supplementation is effective in reducing the incidence and severity of radiation-or chemoradiation-induced mucositis and dermatitis in head and neck cancer patients. The incidence and severity of oral mucositis in the sixth week did not exhibit statistically significant differences between the two groups.…”

“…With this in mind, the European Society for Nutrition and Metabolism guideline states that early screening and assurance about patients' nutritional interventions is crucial in overcoming cancer‐related malnutrition 15 . Prevention and treatment of oral mucositis are essential as malnutrition affects the efficacy of cancer treatment, prognosis, hospitalization period, and the patient's quality of life 16,19 . Early detection and treatment of oral SCC will contribute to a complete cure and 5‐year survival in 85% 20 …”

“…One of the primary studies to investigate the comparative effects of vitamin B12 and folate was done by Branda et 15 Prevention and treatment of oral mucositis are essential as malnutrition affects the efficacy of cancer treatment, prognosis, hospitalization period, and the patient's quality of life. 16,19 Early detection and treatment of oral SCC will contribute to a complete cure and 5-year survival in 85%. 20 The teamwork and support of the various specialists responsible for the care of cancer patients enable the tailoring of nutritional intervention to the clinical situation and the treatment of early toxicity and disease development.…”

Prognostic value of Controlling Nutritional Status score for postoperative complications and biochemical recurrence in prostate cancer patients undergoing laparoscopic radical prostatectomy

“…In recent years, the literature has indicated that impaired nutritional status may affect tolerance to surgery and the prognosis of patients with various types of cancer. [3][4][5] In this context, the Controlling Nutritional Status (CONUT) score was developed by Ignacio de Ulíbarri et al [6] for screening the preoperative nutritional status. This index was calculated based on the preoperative serum albumin concentration, total peripheral blood lymphocyte count, and total cholesterol concentration (Supplementary Table S1, http://links.lww.com/CURRUROL/A46).…”

Analysis of the causes of failed placement of nasoenteric tube under DSA guidance and treatment strategies for successful re-catheterization

“…For patients with advanced malignant tumors or after digestive tract reconstruction, enteral nutrition is crucial for clinical antitumor treatment (1,2), not only because of convenience and efficacy, but also reducing the probability of enterogenous infection and further improving the stress and immune function of patients (3)(4)(5). Patients with advanced malignant tumors can have widely dispersed metastases and different degrees of organ invasion, often resulting in an intestinal obstruction that is difficult to pass with a gastroscopically guided nasoenteric tube.…”