Nutrition Support Interventions for Children and Young People Treated for Osteosarcoma: A Scoping Review

Abstract

Objective: To map evidence for nutrition interventions during osteosarcoma (OS) treatment for children and young people (CYP), identifying gaps to inform research for this predominantly adolescent group. Design: Scoping review following Joanna Briggs Institute methodology and PRISMA-ScR guidelines. Data Sources: MEDLINE, EMBASE, CINAHL, EMCARE and CENTRAL were searched from inception to July 2025 using a three-step search strategy (pilot, full, reference screening). Eligibility Criteria: Studies were included if they assessed nutrition interventions in patients with OS aged < 25 years undergoing treatment. Mixed cancer cohorts were eligible if > 50% had OS or OS data were reported separately. Exclusions: qualitative studies, patients > 25 years, survivors, animal or in vitro studies. Data Extraction and Synthesis: Four reviewers independently screened studies. Data on methodologies, nutrition interventions, outcomes and study design limitations were extracted and reported descriptively. Results: Of 7874 records retrieved, 15 studies (2001–2024) from 4 high- and 4 middle-income countries met inclusion, involving 964 participants (median age 13.3 years), including 5 conference abstracts. Ten studies addressed comprehensive nutrition support (macro- and micronutrients), mostly using retrospective cohorts, while five focused on micronutrients. Common interventions included parenteral nutrition (5/15) and early gastrostomy feeding (5/15). Ten peer-reviewed studies were fully characterised against the review objectives: six examined appetite stimulants, oral, enteral, and parenteral nutrition, or compared early versus reactive gastrostomy, reporting outcomes mainly via BMI Z-scores; four reported gastrostomy complications. Two case reports described thiamine deficiency, and two RCTs assessed magnesium and vitamin D supplementation in relation to febrile neutropenia and survival. Key limitations included small cohorts, incomplete intervention reporting and unvalidated outcome measures. Conclusions: Research on nutrition interventions in CYP with OS is scarce, heterogeneous and methodologically weak. Large, prospective, multi-centre studies are urgently needed to establish evidence-based nutrition support strategies, valid outcome measures, and to examine the psychological impact of tube feeding for young people.