Abstract
BackgroundThe purpose of this systematic review and meta-analysis was to evaluate the effect of a neutropenic diet and a control diet on infection and mortality rates in oncology patients with neutropenia.MethodsWe searched the following English electronic databases: PubMed, Embase, Cochrane Central Register of Controlled Trials, and Google Scholar Engine. Published studies involving neutropenic diets (study group) and control diets (control group) in oncology patients with neutropenia were searched. The focus of the meta-analysis was on the outcomes of infection and mortality rates. A subgroup analysis was also performed.ResultsA total of 6 studies were included, with a total sample size of 1114 patients. The patients in the study group had a similar infection rate compared with the patients in the control group (P = 0.11). The patients in the study group had a similar mortality rate compared with the patients in the control group (P = 0.74). Another subgroup analysis showed that the incidence of infection was also similar for pediatric (P = 0.74) and adult (P = 0.11) oncology patients between the study and control groups.ConclusionsBased on the current evidence, this meta-analysis showed that the application of a neutropenic diet cannot reduce the risk of infection and mortality in oncology patients with neutropenia. However, more rigorous randomized controlled trials are needed to confirm this conclusion in the future.
Highlights
In recent years, the long-term survival rate of oncology patients has gradually increased through multimodal treatment, including chemotherapy [1–3] and radiation therapy [4, 5]
The “standardized diet” in the control group was either a “regular hospital diet” or a diet based on the “Food and Drug Administration (FDA)” approved food safety guidelines
The random effects model was adopted in the meta-analysis since the pooled data did not show statistical heterogeneity (P = 0.64, I2 = 29%) (Figure 6). This is a systematic review and meta-analysis to demonstrate whether neutropenic diets in oncology patients with neutropenia can reduce infection compared to a standardized diet
Summary
The long-term survival rate of oncology patients has gradually increased through multimodal treatment, including chemotherapy [1–3] and radiation therapy [4, 5] In these patients receiving intensive chemotherapy and radiation therapy, immune function [6, 7] and bone marrow cells are inhibited [8, 9], resulting in long-term neutropenia [10–12]. It is understood that patients with cancer may experience dysbiosis or an imbalance between potentially beneficial and pathogenic bacteria [15–17] due to exposure to broad-spectrum antibiotics and certain antitumor agents, as well as changes in intestinal peristalsis and integrity [18, 19]. It potentially increases the risk of infection in these patients. The purpose of this systematic review and meta-analysis was to evaluate the effect of a neutropenic diet and a control diet on infection and mortality rates in oncology patients with neutropenia
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