The effect of oral dietary interventions on nutritional status and treatment tolerance in patients with hematologic neoplasms receiving chemotherapy: a systematic review

Abstract

Abstract Context Adverse events from chemotherapy treatment affect food intake, nutritional status, and treatment tolerance in cancer patients. However, the effect of nutritional intervention in patients with hematologic neoplasms receiving chemotherapy remains unknown. Objective The aim of this systematic review was to evaluate the evidence on nutritional interventions on nutritional status, treatment tolerance, inflammatory markers, quality of life, and mortality in patients with hematologic neoplasms receiving chemotherapy. Data Sources The MEDLINE, LILACS, CINAHL, Web of Science, Embase, ICTRP, CENTRAL, and ClinicalTrials.gov databases were searched. Additional literature and the bibliographies of identified articles were also considered. Data Extraction Randomized controlled trials in individuals with hematologic neoplasms receiving chemotherapy along with nutritional counseling and oral nutritional supplementation, and intake of supplementary food products, alone or in combination, were assessed as criteria of interest. The data were extracted independently by 2 researchers. The risk of bias was assessed through the Cochrane risk-of-bias tool (RoB 2). Data Analysis Ten studies were included up to August 15, 2022 (updated in November of 2022). With regard to the outcomes, 4 studies assessed nutritional status and 2 studies showed a positive result of the intervention on some of the markers. Seven studies assessed certain markers of treatment tolerance and only 2 studies showed improvement in the outcome after the intervention. Conclusion The studies that found positive results are quite different from each other in terms of intervention, study time, and design. More randomized controlled trials are needed to test different dietary interventions using placebo and blinding, when possible, and with reduced sample variability in individuals with hematologic neoplasms receiving chemotherapy. Systematic Review Registration PROSPERO registration no. CRD42020196765.