母親と小児の栄養学
オープンアクセス

概要

An analysis of nutritional aspects and its impact on cancer treatment in pediatric cancer patients

Pooja Gogia

Background: Malnutrition is prevalent in the pediatric population in India. There is paucity of data on the prevalence of malnutrition in pediatric cancer patients and the impact of cancer treatment on nutritional status. Material & Methods: This was a retrospective study of 197 patients of less than 18 years of age at our hospital from May 2012 to June 2015. Data were analyzed at systematic time points in therapy. Patients' weight was plotted on the Centre for Disease Control (CDC) growth charts. Patients were defined to be undernourished if their weight for age was ?3rd centile in CDC growth charts and obese if their weight for age was ?97th centile on CDC growth charts. Results: Out of 197 patients, 110 were solid tumors including brain tumors, retinoblastoma, Ewing’s sarcoma, osteosarcoma, neuroblastoma, Wilms tumor, hepatoblastoma and rest 87 cases were acute lymphoblastic leukemia, acute myeloid leukemia, Hodgkin and non-Hodgkin lymphoma. At diagnosis, under-nutrition was seen in 55% patients, this increased to 60% midway during treatment and decreased to 25% at the end of treatment (P=0.001). Conclusion: Under-nutrition is present in half of the pediatric cancer patients presenting to our hospital. Active nutritional intervention and education were able to significantly reduce the prevalence of under-nutrition in patients at the end of treatment. Malignant tumor growth is the most well-known reason for disease?related passing in kids in industrialized social orders, yet propels in the modalities of medical procedure, radiotherapy, and chemotherapy have prompted significant upgrades in endurance lengths and fix rates for some sorts of threatening maladies in adolescence. The general fix rate currently surpasses 70% and is anticipated to arrive at 85% constantly 2010. It has been evaluated that, from the get-go in the new thousand years, 1 in each 1000 youthful grown-ups between the ages of 20–29 years will have been treated for malignant growth in early life. Nonetheless, 85% of the world's kids live in creating nations, where access to sufficient consideration regularly is constrained, delay in conclusion is normal, and wellbeing status much of the time is affected antagonistically by predominant irresistible sicknesses and lack of healthy sustenance. In nations with restricted assets, it is acknowledged broadly that the predominance of hunger midpoints half in kids with malignant growth; though, in industrialized nations, the pervasiveness of lack of healthy sustenance is identified with the sort of tumor and the degree of the disease5 and is especially basic in patients with cutting edge neuroblastoma, Wilms tumor, and Ewing sarcoma. 46% of kids and youthful grown-ups with malignant growth experience lack of healthy sustenance because of various tumor-and treatment-related elements. It is perceived that a reduced healthful status might be a contributing element for diminished safe capacity, deferred wound recuperating, and upset medication digestion impacting guess. Youngsters with malignant growth are especially defenseless against lack of healthy sustenance, since they display raised substrate needs because of the malady and its treatment. Simultaneously, youngsters have expanded necessities of supplements to achieve suitable development and neurodevelopment. Current data with respect to the pervasiveness of unhealthiness in youth disease is fundamentally impacted by a few variables: 1) distinctive symptomatic strategies to survey the wholesome status; 2) histological sort and phase of harm during appraisal; 3) the youngster's individual defenselessness toward lack of healthy sustenance and anticancer regimens during arrangement; lastly 4) the fairly vague meaning of ailing health. In this manner, the recurrence of undernourishment in youngsters and youths with malignant growth is self-assertive detailed as normal to not existent at conclusion. Studies report a range from 0 to half contingent upon the sort of malignant growth. It must be focused on that body weight is anything but an adequately and satisfactorily delicate marker for the discovery of dietary bothers in kids with disease. It might be influenced by hydration during chemotherapy and doesn't distinguish any drawn out changes in body cell mass. In kids with sufficient or over the top body weight, slender weight misfortune might be covered as fat reductions or stays unaltered while skeletal muscle is squandering. Besides, imperceptible wholesome consumption of at least 1 micronutrients because of diminished food admission, unreasonable enteral misfortunes, or different variables happen in typical or overweight youngsters. Biochemical tests have restricted helpfulness in the assurance of wholesome status, despite the fact that cases in actuality (for prealbumin) have been made for both ALL and strong tumors in kids. Specifically, in spite of the fact that plasma proteins, for example, egg whites, retinol?binding protein, transferrin, and prealbumin, speak to instinctive protein, these are likewise acute?phase reactants. In this way, their levels might be modified by different components, for example, fever and disease. In youngsters with malignant growth, the focuses regularly are discouraged, yet they don't relate with different lists of nourishing status. By the by, there might be a job for such biochemical estimations in the sequential appraisal of dietary status in kids with cancer.In synopsis, these is a reasonable need to create regulating information for development and body structure, particularly for the populaces of youngsters (in creating nations) that contribute the extraordinary lion's share of instances of malignancy. Genuine body weight (and, along these lines, additionally BMI) might be bewildered by enormous tumors, though arm anthropometry offers progressively delicate evaluations of wholesome status that are not all that jumbled.