Literature Review
Volume 7 Issue 6
Agastya Sukhlecha, Charu Sukhlecha* and Seema Kothari
December 07, 2025
Abstract
Background: Malnutrition is common in children with cancer and is associated with worse treatment tolerance, increased infections, relapse risk and reduced survival. This review synthesizes recent evidence about the prevalence of nutritional problems in paediatric oncology, mechanisms linking nutrition to outcomes, and the effect of nutritional assessment and interventions (counselling, oral nutritional supplements, enteral and parenteral nutrition) on prognosis and survival.
Methods: A focused literature search (PubMed, PMC, Scopus, Web of Science) was performed for reviews, guidelines, consensus statements and clinical studies published 2017-2025 using terms “paediatric cancer”, “malnutrition”, “nutritional support”, “enteral nutrition”, “parenteral nutrition”, “survival” and “outcomes”. Priority was given to systematic reviews, consensus statements and large retrospective cohort studies and guideline documents.
Results: Malnutrition at diagnosis and during therapy remains common globally and is associated with treatment interruptions, higher infection rates and worse overall survival. Consensus statements and paediatric-focused reviews recommend early screening, standardized assessment (weight/BMI, MUAC, triceps skinfold, clinical evaluation) and proactive, tiered interventions starting with counselling and ONS and escalating to enteral nutrition (EN) or home parenteral nutrition (HPN) when indicated. Evidence shows that enteral feeding is effective at maintaining or improving weight and nutritional indices and may improve treatment tolerance; parenteral nutrition can correct severe deficits but carries higher infection risk. Observational cohort data link malnutrition to poorer survival and some studies suggest that timely nutritional interventions (standardized screening with early EN/HPN) reduce hospital admissions, improve tolerance to therapy and are associated with better short-term clinical outcomes; however high-quality randomized data examining survival as a primary endpoint are limited.
Conclusions: The preponderance of evidence supports routine nutritional screening and early, multidisciplinary nutritional intervention in paediatric oncology as part of standard supportive care. There is a need for standardized screening protocols, prospective trials of targeted nutritional strategies, and implementation research—especially in lower-resource settings—examining whether early aggressive nutrition improves long-term survival endpoints.
References