Whilst a range of nutrition support interventions for those undergoing osteosarcoma treatment has been studied and interest is growing, the evidence is fragmented, methodologically weak and indicates wide variation in clinical practice. We identify priority research needed to establish evidence-based clinical practice guidance.
ABSTRACT
Objective
To map evidence for nutrition interventions during osteosarcoma (OS) treatment for children and young people (CYP), identifying gaps to inform research for this predominantly adolescent group.
Design
Scoping review following Joanna Briggs Institute methodology and PRISMA-ScR guidelines.
Data Sources
MEDLINE, EMBASE, CINAHL, EMCARE and CENTRAL were searched from inception to July 2025 using a three-step search strategy (pilot, full, reference screening).
Eligibility Criteria
Studies were included if they assessed nutrition interventions in patients with OS aged < 25 years undergoing treatment. Mixed cancer cohorts were eligible if > 50% had OS or OS data were reported separately. Exclusions: qualitative studies, patients > 25 years, survivors, animal or in vitro studies.
Data Extraction and Synthesis
Four reviewers independently screened studies. Data on methodologies, nutrition interventions, outcomes and study design limitations were extracted and reported descriptively.
Results
Of 7874 records retrieved, 15 studies (2001–2024) from 4 high- and 4 middle-income countries met inclusion, involving 964 participants (median age 13.3 years), including 5 conference abstracts. Ten studies addressed comprehensive nutrition support (macro- and micronutrients), mostly using retrospective cohorts, while five focused on micronutrients. Common interventions included parenteral nutrition (5/15) and early gastrostomy feeding (5/15). Ten peer-reviewed studies were fully characterised against the review objectives: six examined appetite stimulants, oral, enteral, and parenteral nutrition, or compared early versus reactive gastrostomy, reporting outcomes mainly via BMI Z-scores; four reported gastrostomy complications. Two case reports described thiamine deficiency, and two RCTs assessed magnesium and vitamin D supplementation in relation to febrile neutropenia and survival. Key limitations included small cohorts, incomplete intervention reporting and unvalidated outcome measures.
Conclusions
Research on nutrition interventions in CYP with OS is scarce, heterogeneous and methodologically weak. Large, prospective, multi-centre studies are urgently needed to establish evidence-based nutrition support strategies, valid outcome measures, and to examine the psychological impact of tube feeding for young people.
Journal of Human Nutrition and Dietetics, Volume 38, Issue 6, December 2025. Read More