Desarrollo de Helados para el Manejo de la Mucositis y del Soporte Nutricional a Pacientes Pediátricos con Cáncer
DOI:
https://doi.org/10.32635/2176-9745.RBC.2023v69n1.3325Palabras clave:
mucositis/prevención & control, crioterapia, estado nutricional, helados, neoplasiasResumen
Introducción: La mucositis es una de las principales complicaciones del tratamiento del cáncer, asociada a varias limitaciones nutricionales y la capacidad de causar infecciones secundarias. La crioterapia es una forma de tratamiento de bajo costo consistente con las guías de práctica clínica para el cuidado de pacientes con mucositis. Objetivo: Desarrollar y evaluar la aceptación de un helado para la prevención y tratamiento de la mucositis y para el apoyo nutricional de pacientes pediátricos con cáncer. Método: Con base en el conocimiento sobre los efectos secundarios de la quimioterapia (especialmente en la mucositis oral y gastrointestinal) y las necesidades nutricionales de los pacientes con cáncer pediátrico, buscamos en la literatura ingredientes que pudieran lograr los objetivos del estudio. El helado fue producido en el Laboratorio de Tecnología de Alimentos de la Universidad Estatal de São Paulo (Unesp), campus de Botucatu y en sociedad con la heladería Sorvetes Naturais del municipio de Botucatu-SP. Se realizó una prueba de aceptación con diez pacientes en tratamiento oncológico y 30 individuos del grupo control utilizando la escala hedónica facial mixta de 5 puntos. Resultados: La fórmula final estuvo compuesta por leche semidesnatada sin lactosa, aceite de coco virgen extra, harina de avena, miel, manzanilla, complemento alimenticio Fortini®, azúcar demerara y estabilizante/emulsionante. El 90% de los pacientes en tratamiento contra el cáncer calificaron el producto final como “me gustó” o “me encantó”, en comparación con el 63% del grupo de control. Conclusión: El desarrollo de un helado que cumpliera con los objetivos del estudio fue posible a través de la elección de su composición. La miel y la manzanilla pueden favorecer la prevención de la mucositis y otros ingredientes ofrecen densidad calórica y aporte proteico.
Descargas
Citas
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
Descargas
Publicado
Cómo citar
Número
Sección
Licencia
Os direitos morais e intelectuais dos artigos pertencem aos respectivos autores, que concedem à RBC o direito de publicação.
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
