P311 - RESTING ENERGY EXPENDITURE IN CHILDREN WITH CANCER: A SYSTEMATIC REVIEW.

P311

RESTING ENERGY EXPENDITURE IN CHILDREN WITH CANCER: A SYSTEMATIC REVIEW.

D. Froon-Torenstra^1,*, L. Renting¹, T. Takken², W. P. Vermeij^1,3, D. E. Kok⁴, W. J. Tissing¹

¹Princess Máxima Center for Pediatric Oncology, ²Department of Medical Physiology, Child Development and Exercise Center, University Medical Center Utrecht, ³Oncode Institute, ⁴Division of Human Nutrition and Health, Wageningen University & Research, Utrecht, Netherlands

Rationale: Malnutrition occurs frequently in children with cancer and can have serious effects on patient outcomes. So far, it remains unclear whether an altered resting energy expenditure (REE) contributes to the development of malnutrition in this population. Here, we summarized current literature comparing measured REE (mREE) in children with cancer to that of healthy peers or predicted REE (pREE) derived from prediction equations.

Methods: To identify relevant publications, Pubmed and Embase were searched up to February 2025. All study designs were eligible for inclusion when they met the following criteria: (1) original studies including children (0-18 years) diagnosed with cancer, (2) that measured REE using indirect calorimetry, and (3) compared mREE with healthy controls or pREE derived from an established prediction equation. An adapted version of the Critical Appraisal Skills Program (CASP) Cohort Study Checklist was used to assess the quality of the included studies.

Results: Of the 1673 identified publications, 12 were eligible for inclusion (total 212 patients). All studies were of relative low quality with small samples sizes (range 7-40 patients). Considerable heterogeneity was observed across the studies with respect to age, diagnosis and treatment phase. Only 2 studies reported significant differences between mREE and healthy controls or pREE. One study reported a higher mREE compared to pREE derived from the Schofield equation in 13 children with newly diagnosed solid tumors, and 1 study reported a lower mREE in 20 children with leukemia during or after treatment compared to healthy controls.

Conclusion: Inconsistent evidence was found for an altered REE in children with cancer. Larger longitudinal studies are needed to fully understand whether changes in REE contribute to the development of malnutrition in this population, and to explore potential differences across tumor types and treatment phases.

Disclosure of Interest: None declared