Immunomodulatory diets in patients with gastrointestinal tract cancer: Integrative review
DOI:
https://doi.org/10.13037/ras.vol19n69.7608Keywords:
mmunomodulation, enteral nutrition, gastrointestinal neoplasmsAbstract
Introduction: The cancer patient undergoes a series of metabolic and nutritional changes due to the disease and the treatments used. Studies reveal that supplementation with enteral formulas and immunomodulatory diets with specific nutrients can improve nutritional status, immune system and act in the modulation of the inflammatory response. Objective: To analyze through the scientific literature, the effects of the use of immunomodulatory diets in surgical patients with cancer of the gastrointestinal tract. Materials and methods: This is an integrative literature review study, carried out from May to July 2020, using articles indexed in the VHL, PubMed and SciELO databases through the descriptors: “enteral nutrition”, “surgery”, “cancer gastrointestinal "," arginine "," omega-3 fatty acids "and" glutamine ", combined with the Boolean operator" and ", available in Portuguese, English and Spanish published in the last 10 years. A total of 236 articles were found and 11 made up the sample after applying the inclusion criteria. Results: Studies demonstrate that supplementation with immunomodulatory diets in surgical patients with cancer of the gastrointestinal tract is effective, since they help to improve the inflammatory and immune response and nutritional status, reducing postoperative complications, allowing for better recovery and reduction of length of hospital stay. Conclusions: Based on the results, nutritional therapy with immunomodulatory diets can help in modulating the immune system, inflammation; reduce oxidative stress and risks of malnutrition in the perioperative period, making it a safe supplement.
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References
Brasil. Ministério da saúde. Instituto Nacional do Câncer. Estimativa 2020: Incidência de câncer no Brasil. Rio de Janeiro: INCA; 2019. Disponível em https://www.inca.gov.br/sites/ufu.sti.inca.local/files//media/document//estimativa-2020-incidencia-de-cancer-no-brasil.pdf. Acesso em 24 abr de 2020.
Barbosa LBG, Fortes RC, Toscano BAF. Impacto de fórmulas enterais imunomoduladoras em pacientes com câncer do trato gastrointestinal enteral: uma revisão da literatura. J Health Sci Inst. 2017;35(1):49-54.
Sociedade Brasileira de Nutrição Parenteral e Enteral. Diretriz BRASPEN de terapia nutricional no paciente com câncer. BRASPEN J. 2019; 34.Supl 1: 2-32.
Ma C, Tsai H, Su W, Sun L, Shih Y, Wang J. Combination of arginine, glutamine, and omega-3 fatty acid supplements for perioperative enteral nutrition in surgical patients with gastric adenocarcinoma or gastrointestinal stromal tumor (GIST): A prospective, randomized, double-blind study. J Postgrad Med. 2018; 64:155–163.
Carmo SG, Fortes RC. Efeitos do uso de fórmulas imunomoduladoras em pacientes cirúrgicos portadores de câncer do trato gastrointestinal. Rev. Cient. Sena Aires. 2019; 8(1):96-111.
Souza JÁ, Gallon WC. Impacto do uso de dieta imunomoduladora e dieta enteral em adultos, durante a quimioterapia e radioterapia em pacientes com câncer de cabeça e pescoço: uma revisão da literatura. BRASPEN J. 2017; 32 (3): 273-81.
Barbosa MV, Queiroz FM, Pinho NB, Martucci RB. Impacto do Uso de Dieta Imunomoduladora em Pacientes com Câncer Colorretal Submetidos a Cirurgias Eletivas com Abreviação de Jejum Pré-operatório. Revista Brasileira de Cancerologia. 2015; 61(3): 217-225.
Mariette, C. Immunonutrition. Journal of Visceral Surgery. 2015; 152, 14–17. doi:10.1016/s1878-7886(15)30005-9
Beyea SC, Nicoll LH. Writing an integrative review. AORN journal. 1998; 67(4).
da Costa Santos CM, de Mattos Pimenta CA, Nobre MRC. A estratégia PICO para a construção da pergunta de pesquisa e busca de evidências. Revista Latino-Americana de Enfermagem. 2007; 15(3).
Moher D, Altman DG, Liberati A, Tetzlaff J. PRISMA statement. Epidemiology. 2008; 22(1):128.
Liu H, Ling W, Shen ZY, Jin X, Cao H. Aplicação clínica da nutrição enteral imunologicamente aprimorada em pacientes com câncer gástrico avançado após gastrectomia total. Journal of Digestive Diseases. 2012; 13(8): 401-406.
Abe T, Hosoi T, Kawai R, Uemura N, Higaki E, An B, et al. A suplementação enteral perioperatória com glutamina, fibra e oligossacarídeo reduz o estresse cirúrgico pós-operatório precoce após a esofagectomia para câncer de esôfago. Esôfago. 2018. Doi: 10.1007 / s10388-
Klek S, Scislo L, Walewska E, Choruz R, Galas A. Enriched enteral nutrition may improve short term survival in stage IV gastric cancer patients, randomized controlled trial, Nutrition. 2016. Doi: 10.1016/j.nut.2016.03.016.
Marano L, Porfidia R, Pezzella M, Grassia M, Petrillo M, Esposito G, et al. Clinical and Immunological Impact of Early Postoperative Enteral Immunonutrition After Total Gastrectomy in Gastric Cancer Patients: A Prospective Randomized Study. Ann Surg Oncol, 2013. Doi 10.1245/s10434-013-3088-1
Nagano T, Fujit H, Tanaka T, Matono S, Murata K, Ishibashi N, et al. A randomized controlled trial comparing antioxidant-enriched enteral nutrition with immune-enhancing enteral nutrition after esophagectomy for cancer: a pilot study. Surg Today, 2012. Doi 10.1007/s00595-012-0424-1
Van Barneveld KWY, Smeets BJJ, Heesakkers FFBM, Bosmans JWAM, Luyer MD, Wasowicz D, et al. Beneficial Effects of Early Enteral Nutrition After Major Rectal Surgery. Critical Care Medicine. 2016; 44(6): e353–361.
Sultan J, Griffin SM, Di Franco F, Kirby JA, Shenton BK, Seal CJ, et al. Ensaio clínico randomizado de nutrição enteral suplementada com ácido graxo ômega-3 versus nutrição enteral padrão em pacientes submetidos à cirurgia de câncer esofagogástrico. British Journal of Surgery. 2012; 99(3): 346–355.
Matsuda Y, Habu D, Lee S, Kishida S, Osugi H. Enteral Diet Enriched with ω-3 Fatty Acid Improves Oxygenation After Thoracic Esophagectomy for Cancer: A Randomized Controlled Trial. World Journal of Surgery. 2017; 41(6): 1584–1594.
Makay O, Kaya T, Firat O, Sozbilen M, Caliskan C, Gezer G, et al. ω-3 Fatty Acids Have No Impact on Serum Lactate Levels After Major Gastric Cancer Surgery. Journal of Parenteral and Enteral Nutrition. 2011; 35(4): 488-492.
Long H, Yang H, Lin Y, Situ D, Liu W. Fish Oil-Supplemented Parenteral Nutrition in Patients Following Esophageal Cancer Surgery: Effect on Inflammation and Immune Function. Nutrition and Cancer. 2013; 65(1):71–75.
Smiderle CA, Gallon CW. Desnutrição em oncologia: revisão de literatura. Rev Bras Nutr Clin. 2012; 27 (4): 250-6.
Damo CC, Pelissaro E, Cibulski TP, Calcing A, Basso T. Câncer gastrintestinal: impacto nutricional em pacientes hospitalizados. BRASPEN J. 2016; 31 (3): 232-6.
Stangherlin L, Barros TP, Bongiolo AM, Silva MA, Castro K, Ceretta LB, et al. Risco nutricional em pacientes com câncer do trato gastrointestinal: métodos diagnósticos. Ciência e saúde. 2018; 11(4):204-210.
Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H, Bozzetti F, et al. Diretrizes ESPEN sobre nutrição em pacientes com câncer. Nutrição clínica. 2017; 36(1):11-48.
Fortes, RC; Waitzberg DL. Efeitos da imunonutrição enteral em pacientes oncológicos submetidos à cirurgia do trato gastrintestinal. Rev Bras Nutr Clin. 2011; 26(4):255-63.
Shao F, Xin F, Yang C, Yang D, Mi Y, Yu J, et al. The Impact of Microbial Immune Enteral Nutrition on the Patients with Acute Radiation Enteritis in Bowel Function and Immune Status. Cell Biochemistry and Biophysics. 2013; 69(2): 357–361.
Chevrou-Séverac, H, Pinget C, Cerantola Y, Demartines N, Wasserfallen J, Schäfer M. Cost-effectiveness analysis of immune-modulating nutritional support for gastrointestinal cancer patients. Clinical Nutrition. 2014; 33(4): 649–654.
Toh JWT, Wilson RB. Pathways of Gastric Carcinogenesis, Helicobacter pylori Virulence and Interactions with Antioxidant Systems, Vitamin C and Phytochemicals. International Journal of Molecular Sciences. 2020; 21(17): 6451.
Garla P, Waitzberg DL, Tesser A. Nutritional Therapy in Gastrointestinal Cancers. Gastroenterology Clinics of North America. 2018; 47(1): 231–242.
Sandrucci S, Beets G, Braga M, Dejong K, Demartines N. Perioperative nutrition and enhanced recovery after surgery in gastrointestinal cancer patients. A position paper by the ESSO task force in collaboration with the ERAS society (ERAS coalition). European Journal of Surgical Oncology. 2018; 44(4), 509–514.
Luo Z, Wang J, Zhang Z, Li H, Huang L, Qiao Y, et al. Efficacy of Early Enteral Immunonutrition on Immune Function and Clinical Outcome for Postoperative Patients With Gastrointestinal Cancer. Journal of Parenteral and Enteral Nutrition. 2017; 014860711771543. doi:10.1177/0148607117715439
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