Growth and nutritional outcomes in children during the first year of cancer treatment: a scoping review with implications for child health care in low- and middle-income countries (LMICs)

Background Improved survival among children with cancer has shifted attention towards quality of care and holistic child health outcomes during treatment. Growth faltering and undernutrition are common during cancer therapy, particularly in low- and middle-income countries (LMICs), where pre-existing nutritional vulnerability and health system constraints may exacerbate this effect. Evidence on growth patterns during the early phase of treatment remains fragmented. Objectives To map available evidence on growth and nutritional outcomes in children with cancer during the first year after diagnosis and initiation of treatment, and to explore implications for child health care delivery in India and similar LMIC settings. Methods A scoping review was conducted using PubMed and Google Scholar. Studies reporting growth or nutritional outcomes in children (≤18 years) with cancer during the first year of treatment were included. Evidence was charted and synthesised descriptively in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA) guidelines. Results and conclusions The initial database search identified 493 titles. After title and abstract screening, 21 articles remained; a further 13 studies were identified through citation search. Four duplicates were removed, resulting in a total of 30 included studies. The literature demonstrates substantial heterogeneity in cancer types, treatment phases, growth indicators and timing of assessments. Most studies focus on weight, with limited reporting of height or growth velocity. Growth faltering is frequently observed during intensive treatment phases. Growth trajectories vary by cancer type and treatment phase, with acute lymphoblastic leukaemia demonstrating progressive adiposity gain and central nervous system tumours showing greater linear growth impairment. Data from LMICs on structured longitudinal growth monitoring and integrated nutritional interventions during treatment are sparse. Routine standardised growth monitoring remains inconsistent in LMIC settings. Integrating structured anthropometric assessment and early nutritional intervention into paediatric oncology care may represent a practical and potentially modifiable strategy to improve growth outcomes in these children.