Desenvolvimento de um Sorvete para Prevenção e Tratamento da Mucosite e Suporte Nutricional a Pacientes Pediátricos com Câncer
DOI:
https://doi.org/10.32635/2176-9745.RBC.2023v69n1.3325Palavras-chave:
mucosite/prevenção & controle, crioterapia, estado nutricional, sorvetes, neoplasiasResumo
Introdução: A mucosite é uma das principais complicações do tratamento oncológico, está associada a várias limitações nutricionais e é capaz de causar infecções secundárias. A crioterapia é uma forma de tratamento de baixo custo, consistente com as diretrizes de prática clínica para o cuidado de pacientes com mucosite. Objetivo: Desenvolver e avaliar a aceitação de um sorvete para prevenção e tratamento da mucosite e para suporte nutricional de pacientes pediátricos com câncer. Método: Baseado no conhecimento sobre os efeitos colaterais da quimioterapia (especialmente na mucosite oral e gastrointestinal) e nas necessidades nutricionais do paciente oncológico pediátrico, buscou-se, na literatura, por ingredientes que pudessem alcançar os objetivos do estudo. O sorvete foi produzido no Laboratório de Tecnologia de Alimentos da Universidade Estadual Paulista (Unesp), campus de Botucatu, e em parceria com a sorveteria Sorvetes Naturais no município de Botucatu-SP. Foi realizado teste de aceitação com dez pacientes em tratamento oncológico e com 30 indivíduos do grupo controle usando a escala hedônica facial mista de 5 pontos. Resultados: A fórmula final consistiu em leite sem lactose semidesnatado, óleo de coco extravirgem, farinha de aveia, mel, camomila, suplemento alimentar Fortini®, açúcar demerara e estabilizante/emulsificante. Dos pacientes em tratamento oncológico, 90% classificaram o produto final em “gostei” ou “adorei”, comparado com 63% do grupo controle. Conclusão: O desenvolvimento de um sorvete que alcançasse os objetivos do estudo foi possível por meio da escolha da sua composição. O mel e a camomila podem favorecer a prevenção da mucosite, e outros ingredientes oferecem densidade calórica e oferta proteica.
Downloads
Referências
Ferlay J, Ervik M, Lam F, et al. Global Cancer Observatory: cancer today [Internet]. Lyon, France: International Agency for Research on Cancer; 2020 [cited 2020 Dec 23]. Available from: https://gco.iarc.fr/today
Van Cutsem E, Arends J. The causes and consequences of cancer-associated malnutrition. Eur J Oncol Nurs 2005;9(Suppl 2):S51-S63. doi: https://doi.org/10.1016/j.ejon.2005.09.007 DOI: https://doi.org/10.1016/j.ejon.2005.09.007
Garófolo A. Diretrizes para terapia nutricional em crianças com câncer em situação crítica. Rev Nutr. 2005;18(4):513-27. doi: https://doi.org/10.1590/S1415-52732005000400007 DOI: https://doi.org/10.1590/S1415-52732005000400007
Murphy AJ, White M, Viani K, et al. Evaluation of the nutrition screening tool for childhood cancer (SCAN). Clin Nutr. 2016;35(1):219-24. doi: https://doi.org/10.1016/j.clnu.2015.02.009 DOI: https://doi.org/10.1016/j.clnu.2015.02.009
Brinksma A, Huizinga G, Sulkers E, et al. Malnutrition in childhood cancer patients: a review on its prevalence and possible causes. Crit Rev Oncol Hematol. 2012;83(2):249-75. doi: https://doi.org/10.1016/j.critrevonc.2011.12.003 DOI: https://doi.org/10.1016/j.critrevonc.2011.12.003
Grosvenor M, Bulcavage L, Chlebowski RT. Symptoms potentially influencing weight loss in a cancer population. Correlations with primary site, nutritional status, and chemotherapy administration. Cancer. 1989;63(2):330-4. doi: https://doi.org/10.1002/1097-0142(19890115)63:2%3C330::aid-cncr2820630221%3E3.0.co;2-u DOI: https://doi.org/10.1002/1097-0142(19890115)63:2<330::AID-CNCR2820630221>3.0.CO;2-U
Horie LM, Barrére APN, Castro MG, et al. Diretriz BRASPEN de terapia nutricional no paciente com câncer e BRASPEN recomenda: indicadores de qualidade em terapia nutricional. Braspen J [Internet]. 2019 [acesso 2020 dez 23];34(Suppl 1):2-32. Disponível em: https://www.braspen.org/_files/ugd/a8daef_19da407c192146e085edf67dc0f85106.pdf
Instituto Nacional de Câncer José Alencar Gomes da Silva. Consenso nacional de nutrição oncológica [Internet]. 2. ed. rev., amp. atual. Rio de Janeiro: INCA; 2015 [acesso 2018 dez 26]. Disponível em: https://www.inca.gov.br/sites/ufu.sti.inca.local/files//media/document/consenso_nacional_de_nutricao_oncologica_-_2a_edicao_2015_completo_0.pdf
Kwon Y. Mechanism-based management for mucositis: option for treating side effects without compromising the efficacy of cancer therapy. Onco Targets Ther. 2016;9:2007-16. doi: https://doi.org/10.2147/OTT.S96899 DOI: https://doi.org/10.2147/OTT.S96899
Chaveli-López B, Bagán-Sebastián JV. Treatment of oral mucositis due to chemotherapy. J Clin Exp Dent. 2016;8(2):e201-9. doi: https://doi.org/10.4317/jced.52917 DOI: https://doi.org/10.4317/jced.52917
Fliedner M, Baguet B, Blankart J, et al. Palifermin for patients with haematological malignancies: Shifting nursing practice from symptom relief to prevention of oral mucositis. Eur J Oncol Nurs. 2007;11(Suppl 1):S19-S26. doi: https://doi.org/10.1016/S1462-3889(07)70004-2 DOI: https://doi.org/10.1016/S1462-3889(07)70004-2
Hohloch K, Zeynalova S, Chapuy B, et al. Modified BEAM with triple autologous stem cell transplantation for patients with relapsed aggressive non-Hodgkin lymphoma. Ann Hematol. 2016;95(7):1121-8. doi: https://doi.org/10.1007/s00277-016-2671-5 DOI: https://doi.org/10.1007/s00277-016-2671-5
Spolarich AE. Risk management strategies for reducing oral adverse drug events. J Evid Based Dent Pract. 2014;14(Suppl):87-94.e1. doi: https://doi.org/10.1016/j.jebdp.2014.04.009 DOI: https://doi.org/10.1016/j.jebdp.2014.04.009
Peterson DE, Bensadoun RJ, Roila F, et al. Management of oral and gastrointestinal mucositis: ESMO clinical practice guidelines. Ann Oncol. 2011;22(Suppl 6):vi78-vi84. doi: https://doi.org/10.1093/annonc/mdr391 DOI: https://doi.org/10.1093/annonc/mdr391
Eilers J, Million R. Clinical update: prevention and management of oral mucositis in patients with cancer. Semin Oncol Nurs. 2011;27(4):e1-e16. doi: https://doi.org/10.1016/j.soncn.2011.08.001 DOI: https://doi.org/10.1016/j.soncn.2011.08.001
Bezinelli LM, de Paula Eduardo F, da Graça Lopes RM, et al. Cost-effectiveness of the introduction of specialized oral care with laser therapy in hematopoietic stem cell transplantation. Hematol Oncol. 2014;32(1):31-9. doi: https://doi.org/10.1002/hon.2050 DOI: https://doi.org/10.1002/hon.2050
Bezinelli LM, Eduardo FP, Neves VD, et al. Quality of life related to oral mucositis of patients undergoing haematopoietic stem cell transplantation and receiving specialised oral care with low-level laser therapy: a prospective observational study. Eur J Cancer Care (Engl). 2016;25(4):668-74. doi: https://doi.org/10.1111/ecc.12344 DOI: https://doi.org/10.1111/ecc.12344
Sonis ST. Health and economic consequences of mucositis. London: Springer Healthcare; 2012. Chapter 4, Oral mucositis; p. 25-9. doi: https://doi.org/10.1007/978-1-907673-46-7_4 DOI: https://doi.org/10.1007/978-1-907673-46-7_4
Al-Dasooqi N, Gibson RJ, Bowen JM, et al. Matrix metalloproteinases are possible mediators for the development of alimentary tract mucositis in the dark agouti rat. Exp Biol Med (Maywood). 2010;235(10):1244-56. doi: https://doi.org/10.1258/ebm.2010.010082 DOI: https://doi.org/10.1258/ebm.2010.010082
Cinausero M, Aprile G, Ermacora P, et al. New frontiers in the pathobiology and treatment of cancer regimen-related mucosal injury. Front Pharmacol. 2017;8:354. doi: https://doi.org/10.3389/fphar.2017.00354 DOI: https://doi.org/10.3389/fphar.2017.00354
Green R, Horn H, Erickson JM. Eating experiences of children and adolescents with chemotherapy-related nausea and mucositis. J Pediatr Oncol Nurs. 2010;27(40):209-16. doi: https://doi.org/10.1177/1043454209360779 DOI: https://doi.org/10.1177/1043454209360779
Bechard LJ, Guinan EC, Feldman HA, et al. Prognostic factors in the resumption of oral dietary intake after allogeneic hematopoietic stem cell transplantation (HSCT) in Children. JPEN J Parenter Enteral Nutr. 2007;31(4):295-301. doi: https://doi.org/10.1177/0148607107031004295 DOI: https://doi.org/10.1177/0148607107031004295
Kuiken NSS, Rings EHHM, Tissing WJE. Risk analysis, diagnosis and management of gastrointestinal mucositis in pediatric cancer patients. Crit Rev Oncol Hematol. 2015;94(1):87-97. doi: https://doi.org/10.1016/j.critrevonc.2014.12.009 DOI: https://doi.org/10.1016/j.critrevonc.2014.12.009
Riley P, Glenny AM, Worthington HV, et al. Interventions for preventing oral mucositis in patients with cancer receiving treatment: oral cryotherapy. Cochrane Database Syst Rev. 2015;2015(12):CD011552. doi: https://doi.org/10.1002/14651858.CD011552.pub2 DOI: https://doi.org/10.1002/14651858.CD011552
Wang L, Gu Z, Zhai R, et al. Efficacy of oral cryotherapy on oral mucositis prevention in patients with hematological malignancies undergoing hematopoietic stem cell transplantation: a meta-analysis of randomized controlled trials. PLoS One. 2015;10(5):e0128763. doi: https://doi.org/10.1371/journal.pone.0128763 DOI: https://doi.org/10.1371/journal.pone.0128763
Karagözoğlu S, Filiz Ulusoy M. Chemotherapy: the effect of oral cryotherapy on the development of mucositis. J Clin Nurs. 2005;14(6):754-65. doi: https://doi.org/10.1111/j.1365-2702.2005.01128.x DOI: https://doi.org/10.1111/j.1365-2702.2005.01128.x
Peterson DE, Lalla RV. Oral mucositis: the new paradigms. Curr Opin Oncol. 2010;22(4):318-22. doi: https://doi.org/10.1097/CCO.0b013e32833a9fab DOI: https://doi.org/10.1097/CCO.0b013e32833a9fab
Peterson DE, Ohrn K, Bowen J, et al. Systematic review of oral cryotherapy for management of oral mucositis caused by cancer therapy. Support Care Cancer. 2013;21(1):327-32. doi: https://doi.org/10.1007/s00520-012-1562-0 DOI: https://doi.org/10.1007/s00520-012-1562-0
Lalla RV, Bowen J, Barasch A, et al. MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy. Cancer. 2014;120(10):1453-61. doi: https://doi.org/10.1002/cncr.28592 DOI: https://doi.org/10.1002/cncr.28592
Elad S, Cheng KKF, Lalla RV, et al. MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy. Cancer. 2020;126(19):4423-31. doi: https://doi.org/10.1002/cncr.33100 DOI: https://doi.org/10.1002/cncr.33100
Hyams JS, Batrus CL, Grand RJ, et al. Cancer chemotherapy-induced lactose malabsorption in children. Cancer. 1982;49(4):646-50. doi: https://doi.org/10.1002/1097-0142(19820215)49:4<646::AID-CNCR2820490407>3.0.CO;2-M DOI: https://doi.org/10.1002/1097-0142(19820215)49:4<646::AID-CNCR2820490407>3.0.CO;2-M
Gomes VTS, Gomes RNS, Gomes MS, et al. Effects of matricaria recutita (L.) in the treatment of oral mucositis. Sci World J. 2018;2018:4392184. doi: https://doi.org/10.1155/2018/4392184 DOI: https://doi.org/10.1155/2018/4392184
Reis PED, Ciol MA, Melo NS, et al. Chamomile infusion cryotherapy to prevent oral mucositis induced by chemotherapy: a pilot study. Support Care Cancer. 2016;24(10):4393-8. doi: https://doi.org/10.1007/s00520-016-3279-y DOI: https://doi.org/10.1007/s00520-016-3279-y
Liu TM, Luo YW, Tam KW, et al. Prophylactic and therapeutic effects of honey on radiochemotherapy-induced mucositis: a meta-analysis of randomized controlled trials. Support Care Cancer. 2019;27(7):2361-70. doi: https://doi.org/10.1007/s00520-019-04722-3 DOI: https://doi.org/10.1007/s00520-019-04722-3
Münstedt K, Momm F, Hübner J. Honey in the management of side effects of radiotherapy- or radio/chemotherapy-induced oral mucositis. A systematic review. Complement Ther Clin Pract. 2019;34:145-52. doi: https://doi.org/10.1016/j.ctcp.2018.11.016 DOI: https://doi.org/10.1016/j.ctcp.2018.11.016
Sang S, Chu YF. Whole grain oats, more than just a fiber: role of unique phytochemicals. Mol Nutr Food Res. 2017;61(7):1600715. doi: https://doi.org/10.1002/mnfr.201600715 DOI: https://doi.org/10.1002/mnfr.201600715
Boateng L, Ansong R, Owusu WB, et al. Coconut oil and palm oil’s role in nutrition, health and national development: a review. Ghana Med J. 2016;50(3):189-96. doi: https://doi.org/10.4314/gmj.v50i3.11 DOI: https://doi.org/10.4314/gmj.v50i3.11
Sturion GL. Programa de alimentação escolar: avaliação do desempenho em dez municípios brasileiros [tese]. Campinas (SP): Universidade Estadual de Campinas; 2001.
Ministério da Educação (BR). Manual para aplicação dos testes de aceitabilidade no Programa Nacional de Alimentação Escolar (PNAE) [Internet]. 2. ed. rev. atual. Brasília (DF): Ministério da Educação; 2017 [acesso 2020 dez 26]. Disponível em: http://www.fnde.gov.br/index.php/centrais-de-conteudos/publicacoes/category/110-alimentacao-e-nutricao?download=5096:manual-para-aplicacao-dos-testes-de-aceitabilidade-no-pnae
Kibon [Internet]. São Paulo (SP): Unilever; c2023. Fruttare Coco [acesso 2020 dez 26]. Disponível em: https://www.kibon.com.br/nossas-marcas/fruttare/fruttare-coco.html
Mishra L, Nayak G. Effect of flavored (Honey and Tulsi) ice chips on reduction of oral mucositis among children receiving chemo therapy. Int J Pharm Sci Rev Res. 2017;43(1):25-8.
Nikoletti S, Hyde S, Shaw T, et al. Comparison of plain ice and flavoured ice for preventing oral mucositis associated with the use of 5 fluorouracil. J Clin Nurs. 2005;14(6):750-3. doi: https://doi.org/10.1111/j.1365-2702.2005.01156.x DOI: https://doi.org/10.1111/j.1365-2702.2005.01156.x
Trinidade A, Martinelli K, Andreou Z, et al. Soft, fortified ice-cream for head and neck cancer patients: a useful first step in nutritional and swallowing difficulties associated with multi-modal management. Eur Arch Otorhinolaryngol. 2012;269(4):1257-60. doi: https://doi.org/10.1007/s00405-011-1769-6 DOI: https://doi.org/10.1007/s00405-011-1769-6
Casas F, León C, Jovell E, et al. Adapted ice cream as a nutritional supplement in cancer patients: impact on quality of life and nutritional status. Clin Transl Oncol. 2012;14(1):66-72. doi: https://doi.org/10.1007/s12094-012-0763-9 DOI: https://doi.org/10.1007/s12094-012-0763-9
Palmieri BN, Moulatlet EM, Buschinelli LKO, et al. Aceitação de preparações e sua associação com os sintomas decorrentes do tratamento de câncer em pacientes de uma clínica especializada. Cad Saúde Colet. 2013;21(1):2-9. doi: https://doi.org/10.1590/s1414-462x2013000100002 DOI: https://doi.org/10.1590/S1414-462X2013000100002
Vieira FGK, De Salles RK, Mannes P, et al. Development and acceptance of an ice cream as food alternative for cancer patients. J Culin Sci Technol. 2020;18(2):89-97. doi: https://doi.org/10.1080/15428052.2018.1509752 DOI: https://doi.org/10.1080/15428052.2018.1509752
Okkels SL, Bredie WLP, Klausen TW, et al. An investigation into between-meal food desires among hospitalised haematological cancer patients. Clin Nutr. 2016;35(2):440-5. doi: https://doi.org/10.1016/j.clnu.2015.03.010 DOI: https://doi.org/10.1016/j.clnu.2015.03.010
Magalhães ES, Oliveira AEM, Cunha NB. Atuação do nutricionista para melhora da qualidade de vida de pacientes oncológicos em cuidados paliativos. Arch Health Sci. 2018;25(3):4-9. doi: https://doi.org/10.17696/2318-3691.25.3.2018.1032 DOI: https://doi.org/10.17696/2318-3691.25.3.2018.1032
Bellows LL, Johnson SL, Davies PL, et al. The Colorado LEAP study: rationale and design of a study to assess the short term longitudinal effectiveness of a preschool nutrition and physical activity program. BMC Public Health. 2013;13:1146. doi: https://doi.org/10.1186/1471-2458-13-1146 DOI: https://doi.org/10.1186/1471-2458-13-1146
Robinson S, Fall C. Infant nutrition and later health: a review of current evidence. Nutrients. 2012;4(8):859-74. doi: https://doi.org/10.3390/nu4080859 DOI: https://doi.org/10.3390/nu4080859
Hetherington MM, Schwartz C, Madrelle J, et al. A step-by-step introduction to vegetables at the beginning of complementary feeding. The effects of early and repeated exposure. Appetite. 2015;84:280-90. doi: https://doi.org/10.1016/j.appet.2014.10.014 DOI: https://doi.org/10.1016/j.appet.2014.10.014
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Os direitos morais e intelectuais dos artigos pertencem aos respectivos autores, que concedem à RBC o direito de publicação.
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
