The role of nutritional support in advanced cancer: a systematic review of weight, quality of life, and treatment tolerance outcomes

Abstract

Background: Malnutrition and cachexia are prevalent in advanced cancer patients, contributing to decreased treatment tolerance, impaired quality of life, and reduced survival [1]. Nutritional interventions, including oral nutritional supplements, enteral nutrition, and parenteral nutrition, have been employed to mitigate these effects [2]. Objective: This systematic review aimed to evaluate the impact of nutritional support interventions on key outcomes in adult patients with advanced cancer, including survival, quality of life, weight stabilization, functional status, treatment tolerance, and biochemical markers [3]. Methods: A comprehensive literature search was performed in accordance with the PRISMA 2020 guidelines [4] in CENTRAL, PubMed, and Google Scholar for studies published in English within the past 10 years. Eligible studies comprised randomized controlled trials, prospective cohort studies, and observational studies that assessed nutritional interventions in advanced cancer patients. Data extraction and risk of bias assessments were conducted independently by reviewers using the Cochrane Risk of Bias (RoB) and Joanna Briggs Institute (JBI) tools [5]. Results: Nine studies involving 799 patients from eight countries were included. Nutritional interventions were associated with improvements in weight stabilization, lean body mass, and biochemical markers such as albumin and prealbumin [6]. Functional status was enhanced, particularly when nutritional support was combined with exercise, although the effect on overall survival was inconsistent [7]. Notably, parenteral nutrition was linked to a higher risk of infections, whereas oral supplementation and multimodal strategies demonstrated higher adherence and fewer adverse events [8]. Conclusion: Individualized multimodal nutritional support may improve treatment tolerance, quality of life, and key nutritional parameters in advanced cancer patients, although its impact on survival remains uncertain [9]. Future research should focus on standardized protocols and precision nutrition approaches to optimize outcomes in this vulnerable population [10].