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Review
Published: 04-28-2025

Clinical outcomes and guidelines for nutrological therapy and palliative medicine in cancer patients: a systematic review

University Hospital, UFPI- University Campus Minister Petrônio Portela, Ininga, Teresina, Piauí, Brazil
Dorio Silva State Hospital. Eldes Scherrer Souza, Laranjeiras Residential Park, Serra, Espírito Santo, Brazil
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
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
Nutritional therapy Palliative care Chronic diseases Survival

Abstract

Introduction: Nutritional support for cancer patients in palliative care is still a controversial topic. Dietary counseling, providing nutritional support, and alleviating diet-related issues should be an essential components of a holistic approach to palliative and end-of-life care. Objective: It was to carry out a systematic review to explore and discuss the main approaches to nutritional therapy in palliative care in cancer patients. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from August to September 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: 141 articles were found. A total of 46 articles were evaluated in full and 21 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 23 studies with a high risk of bias and 28 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X2=84.5%>50%. It was concluded that the use of the modified Glasgow Prognostic Score to identify the existence and severity of CC, which is associated with function, has the potential to assist in clinical decision-making regarding the indication of enteral nutrition in patients with incurable cancer undergoing palliative care. There are not enough quality studies that provide evidence of the improvement in health status and quality of life when using enteral nutrition through NGT in patients receiving palliative care. For this reason, decision-making in this field must be carried out on an individual basis, weighing up the benefits and harms that can be caused to patients' quality of life. The guidelines recommend that, if oral food intake remains inadequate despite counseling and oral nutritional supplements, enteral nutrition or, if this is not sufficient or feasible, parenteral nutrition (supplemental or total) should be considered.

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How to Cite

Carvalho, R. de O., Lopes, . L. M. de A., Santos, K. G. C., Soares, V. C., Lima, S. R. P. de M., Oliveira, S. D. de, Oliveira, D. S. de, Araujo, J. A. A. de, Oliveira, S. B. de, & Lopes, H. M. (2025). Clinical outcomes and guidelines for nutrological therapy and palliative medicine in cancer patients: a systematic review. International Journal of Nutrology, 18(S2). https://doi.org/10.54448/ijn25S205