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Review
Published: 04-28-2025

Nutrological and pharmacological therapy in patients with neoplasms and cachexia: a systematic review

CHAMA Hospital, Senador Arnon de Melo Neighborhood, Arapiraca, Alagoas, Brazil
Mãe Luzia Women's Hospital. Obstetric ICU. Avenue Fab, 81 - Central, Macapá, Amapá, Brazil
Clinort. Dr. João Medeiros Filho Avenue, 500, Igapó, Natal, Rio Grande do Norte, Brazil
Dorio Silva State Hospital. Eldes Scherrer Souza, Laranjeiras Residential Park, Serra, Espírito Santo, Brazil
University Hospital, UFPI- University Campus Minister Petrônio Portela, Ininga, Teresina, Piauí, Brazil
Federal University of Rio de Janeiro. Maternity School. 180 Laranjeiras Street, Rio de Janeiro, Brazil
Cardiocare - Mato Grosso Street, 1114 1st floor. 86010180 Londrina, Paraná, Brazil
Odara LifeStyle Wellness Clinic, São Paulo. Brazilian Society of Integrative Functional Medicine, São Paulo, Brazil
Vital Heart Clinic. Barão do Rio Branco Avenue, 615. 9th Floor. Joaçaba, Santa Catarina, Brazil
Nossa Senhora das Graças Hospital. Street: Visconde de Jequitinhonha, 1144, Boa Viagem, Recife, Pernambuco, Brazil
Nutrological therapy Cancer Cachexia Pharmacological treatments

Abstract

Introduction: Cancer cachexia (CC) is a multifactorial syndrome that is generally characterized by continuous loss of skeletal muscle mass with or without fat loss, often accompanied by anorexia, weakness, and fatigue. Cancer cachexia is associated with low tolerance to antitumor treatments, reduced quality of life, and a negative impact on survival. Unintentional weight loss has been associated with a negative impact on multiple outcomes in cancer patients, including survival and quality of life. Objective: It was to present the main evidence of nutritional and pharmacological therapy for cachectic cancer patients through a systematic review. Methods: The systematic review rules of the PRISMA Platform were followed. The search was conducted from June to August 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 105 articles were found. 51 articles were assessed and 14 were included in this systematic review. Considering the Cochrane risk of bias tool, the overall assessment resulted in 11 studies with a high risk of bias and 22 studies that did not meet the GRADE criteria. It was concluded that the nutritional consequences of cancer treatments should be identified early with screening and assessment of nutritional status. Nutritional intervention includes screening and appropriate nutritional assessment, which should begin early in the course of the disease to reduce or delay negative effects on therapy and quality of life. Liquid nutritional supplements may be useful to help increase caloric intake. Numerous investigations have reported orexigenic activity associated with progestational agents, such as megestrol acetate and medroxyprogesterone. Megestrol acetate has received the most attention in randomized clinical trials of cancer patients. The use of corticosteroids and mirtazapine for weight gain and pain control was also highlighted. Enteral immunonutrition is an effective nutritional intervention that improves immune function in patients undergoing gastric cancer surgery.

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How to Cite

Santos, K. G. C., Soares, V. C., Lima, S. R. P. de M., Lopes, L. M. de A., Carvalho, R. de O., Oliveira, S. D. de, Oliveira, D. S. de, Araujo, J. A. A. de, Oliveira, S. B. de, & Lopes, H. M. (2025). Nutrological and pharmacological therapy in patients with neoplasms and cachexia: a systematic review. International Journal of Nutrology, 18(S2). https://doi.org/10.54448/ijn25S203