Background: A systematic evaluation and meta-analysis of randomized controlled trials (RCTs) was conducted to assess the impact of immunonutritional interventions on sarcopenia in oncology patients. Methods: A computerized search of the PubMed, Embase, the Cochrane Library, and Web of Science databases was performed. The studies included in the final analyses encompassed 7 high-quality RCTs, involving 432 tumor patients. The intervention group received immunonutritional supplements enriched with omega-3 fatty acids, arginine, glutamine, and other nutrients. The control group received a standard diet or a placebo. Primary outcome indicators included muscle mass, body weight, body mass index (BMI), inflammatory markers e.g., C-reactive protein (CRP), interleukin (IL)-6, and patient prognosis. The study followed the PRISMA 2020 guidelines. Results: Meta-analyses showed that immunonutritional interventions reduced IL-6 levels compared with the control group (mean=−5.85, 95% CI : −10.88 to −0.82, P =0.02). No significant differences were observed in the body weight (mean =−1.50, 95% CI :−6.24 to 3.24, I 2 =0, P =0.54), BMI (mean =−0.38, 95% CI : −1.84 to 1.09, I 2 =0, P =0.61), handgrip strength (mean =1.97, 95% CI : −2.94 to 6.88, I 2 =0, P =0.43), or fat tissue index (mean =0.70, 95% CI : −0.56 to 1.97, I 2 =0, P =0.27). CRP levels showed a nonsignificant downward trend in the intervention group (mean =−4.13, 95% CI : −13.63 to 5.38, I 2 =66%, P =0.39), with high heterogeneity potentially attributable to differences in trial design, patients’ baseline status, and intervention methods. Risk of bias assessment confirmed the high quality of the included studies. Conclusions: Immunonutritional interventions may modulate inflammatory responses in oncology patients, particularly those at higher nutritional risk, but their effect on enhancing muscle mass was not statistically confirmed. Impacts on body weight and BMI remain ambiguous, potentially influenced by factors such as the specific intervention administered, its duration, the concentrations of the different components, and the patients’ baseline status. This study provides preliminary support for immunonutrition in managing sarcopenia in oncology patients; however, additional high-quality RCTs with larger sample sizes and standardized protocols are needed to further substantiate the efficacy and safety of the interventions, thereby providing a more robust evidence-based foundation for clinical practice.
Wang et al. (Fri,) studied this question.