Introduction. Neuroblastoma is an aggressive pediatric malignancy where nutritional deficiencies profoundly impact treatment tolerance, prognosis and quality of life. This narrative review synthesizes current literature on nutritional management strategies in children diagnosed with neuroblastoma. Methodology. A comprehensive search was conducted across PubMed, Scopus and Web of Science databases for studies on nutritional status, dietary interventions and nutraceuticals in pediatric neuroblastoma. Results. The available data indicate that malnutrition is prevalent in neuroblastoma patients, driven by disease- and treatment-induced anorexia, rather than by elevated resting energy expenditure. Adequate macronutrient intake, particularly protein, and moderate physical activity are crucial. Preclinical studies show the ketogenic diet’s promise as an adjuvant therapy by modulating tumor metabolism, yet rigorous controlled clinical studies are needed to evaluate the safety and efficacy of this type of intervention. Nutraceuticals such as curcumin, allicin and resveratrol demonstrate anticancer mechanisms in vitro and in animal models, but they require extensive clinical trials to establish pediatric efficacy and safety. Vitamin D’s role in general supplementation remains inconclusive, though individualized assessment may be beneficial. Effective management necessitates early, comprehensive assessments (e.g., 24-hour dietary recalls) and sustained interventions. Conclusions. Malnutrition represent a significant negative prognostic factor for children with neuroblastoma, requiring specialized intervention. While ketogenic diets and certain nutraceuticals show therapeutic potential, their clinical integration awaits robust supplementary investigations. Multidisciplinary approaches are essential to improve the outcomes in this category of patients.
Martin-Hadmaș et al. (Thu,) studied this question.