Volume 16, Issue 2 (3-2026)
Iran J Ped Hematol Oncol 2026, 16(2): 879-892 |
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Heidary M, Shaker M, Nazmieh H, Mehrabani S, Owliaey H, Taghvaei M et al . The Role of Nutrition in Pediatric Cancer: From Mechanisms to Clinical Impact. Iran J Ped Hematol Oncol 2026; 16 (2) :879-892
URL: http://ijpho.ssu.ac.ir/article-1-973-en.html
URL: http://ijpho.ssu.ac.ir/article-1-973-en.html
Mahboobeh Heidary 
, Marzieh Shaker , Hossein Nazmieh , Sanaz Mehrabani , Hamid Owliaey , Motahare Taghvaei * , Elnaz Sheikhpour
, Marzieh Shaker , Hossein Nazmieh , Sanaz Mehrabani , Hamid Owliaey , Motahare Taghvaei * , Elnaz Sheikhpour
Department of Pediatrics, Shahid Sadoughi Hospital,Shahid Sadoughi University of Medical Sciences, Yazd, Iran & Department of Pediatrics, Shahid Sadoughi Hospital,Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Abstract: (12 Views)
Pediatric cancer poses a growing public health challenge, particularly in low- and middle-income countries. While advances in diagnostics and multimodal treatments have improved survival rates, treatment-related complications—especially malnutrition—remain a critical concern. Malnutrition, encompassing both undernutrition and overnutrition, affects up to 70% of children undergoing cancer therapy and significantly impacts treatment outcomes, quality of life, and survival.
The nutritional status of pediatric cancer patients is influenced by tumor-related metabolic demands, treatment side effects, and socioeconomic factors. Chemotherapy, radiotherapy, and surgery often lead to anorexia, vomiting, mucositis, and metabolic disturbances that reduce nutrient intake and alter body composition. These changes result in impaired immunity, organ dysfunction, increased infection risk, and altered pharmacokinetics of chemotherapeutic agents. Both undernutrition and obesity are independently associated with increased treatment-related toxicity and reduced survival, particularly in solid tumors and lymphomas.
Biologically, cancer alters systemic metabolism through mechanisms like increased glycolysis (Warburg effect), where tumor cells preferentially convert glucose to lactate—even in the presence of oxygen—leading to inefficient energy use and muscle catabolism. Additionally, cytokines (e.g., IL-6, TNF-α) and tumor-derived catabolic factors (e.g., PIF, LMF) accelerate lipolysis and proteolysis, depleting fat and lean mass. This metabolic derangement contributes to cancer cachexia and protein-energy malnutrition, especially in children with advanced disease.
Micronutrient deficiencies—particularly in vitamins D, C, B12, zinc, and selenium—are also highly prevalent and further compromise immune and metabolic function. Though data on supplementation outcomes remain inconclusive, routine screening and correction are recommended.
Moreover, emerging evidence suggests that specific nutrients—such as omega-3 fatty acids—may provide additional therapeutic benefits by modulating inflammation and preserving lean body mass. Ultimately, a proactive and personalized nutritional approach is critical to improving treatment outcomes, reducing complications, and enhancing the overall well-being of children with cancer. Future studies should further be done in this regard.
The nutritional status of pediatric cancer patients is influenced by tumor-related metabolic demands, treatment side effects, and socioeconomic factors. Chemotherapy, radiotherapy, and surgery often lead to anorexia, vomiting, mucositis, and metabolic disturbances that reduce nutrient intake and alter body composition. These changes result in impaired immunity, organ dysfunction, increased infection risk, and altered pharmacokinetics of chemotherapeutic agents. Both undernutrition and obesity are independently associated with increased treatment-related toxicity and reduced survival, particularly in solid tumors and lymphomas.
Biologically, cancer alters systemic metabolism through mechanisms like increased glycolysis (Warburg effect), where tumor cells preferentially convert glucose to lactate—even in the presence of oxygen—leading to inefficient energy use and muscle catabolism. Additionally, cytokines (e.g., IL-6, TNF-α) and tumor-derived catabolic factors (e.g., PIF, LMF) accelerate lipolysis and proteolysis, depleting fat and lean mass. This metabolic derangement contributes to cancer cachexia and protein-energy malnutrition, especially in children with advanced disease.
Micronutrient deficiencies—particularly in vitamins D, C, B12, zinc, and selenium—are also highly prevalent and further compromise immune and metabolic function. Though data on supplementation outcomes remain inconclusive, routine screening and correction are recommended.
Moreover, emerging evidence suggests that specific nutrients—such as omega-3 fatty acids—may provide additional therapeutic benefits by modulating inflammation and preserving lean body mass. Ultimately, a proactive and personalized nutritional approach is critical to improving treatment outcomes, reducing complications, and enhancing the overall well-being of children with cancer. Future studies should further be done in this regard.
Type of Study: Review |
Subject:
Nutrition
Received: 2025/08/7 | Accepted: 2025/09/6 | Published: 2026/03/30
Received: 2025/08/7 | Accepted: 2025/09/6 | Published: 2026/03/30
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