PURPOSE Recent guidelines by the European Society for Clinical Nutrition and Metabolism (ESPEN) have advocated increased attention to nutritional support in all patients with cancer; however, little is known about the optimal type of nutritional intervention. The aim of this review was to assess the current evidence for nutrition support in patients with incurable cancer. METHODS This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Embase, MEDLINE and CINAHL were searched from 1990 to 2018. Evidence was appraised using a modified risk of bias table, based on guidance from the Cochrane Handbook for Systematic Reviews of Interventions. RESULTS Sixty studies were assessed of which twelve met the eligibility criteria. Eleven studies examined body composition, with six studies reporting improvements in weight. Six studies examined nutritional status with three studies reporting an improvement. Nine studies examined nutritional intake with six showing improvements including significant improvements in dietary and protein intake. Ten studies examined quality of life, with six studies reporting improvements following intervention. The most common nutritional interventions examined were nutrition counselling and dietary supplementation. CONCLUSIONS There is moderate quality evidence to support the need for increased attention to nutrition support in patients with incurable cancer; however, despite some statistically significant results being reported, the clinical effects of them were small. Key questions remain as to the optimal timing for these interventions to be implemented (e.g. cachexia stage, illness stage and timing with anticancer therapy) and the most appropriate endpoint measures.

中文翻译：

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对不治之症患者进行营养支持干预的系统评价。

目的欧洲临床营养与代谢学会（ESPEN）的最新指南提倡对所有癌症患者的营养支持给予更多关注；然而，人们对营养干预的最佳类型知之甚少。这篇综述的目的是评估目前无法治愈的癌症患者营养支持的证据。方法根据系统评价和荟萃分析的首选报告项目（PRISMA）指南进行此评价。从1990年至2018年对Embase，MEDLINE和CINAHL进行了搜索。根据Cochrane系统干预评论手册的指导，使用修正的偏倚风险表对证据进行评估。结果评估了60项研究，其中12项符合资格标准。十一项研究检查了身体成分，有六项研究报告了体重的改善。六项研究检查了营养状况，三项研究报告了营养状况得到改善。九项研究检查了营养摄入，其中六项显示改善，包括饮食和蛋白质摄入显着改善。十项研究检查了生活质量，其中六项研究报告了干预后的生活质量得到改善。最常见的营养干预措施是营养咨询和饮食补充。结论有中等质量的证据支持需要进一步关注无法治愈的癌症患者的营养支持。然而，尽管报道了一些统计学上显着的结果，但它们的临床效果很小。关键问题仍然在于实施这些干预措施的最佳时机（例如恶病质阶段，