M-P Vasson1, J Talvas2, O Perche2, A-F Dillies3, P Bachmann4, D Pezet5, A-C Achim6, P Pommier7, S Racadot4, A Weber8, M Ramdani8, F Kwiatkowski9, C Bouteloup10. 1. CHU Clermont-Ferrand, Centre Jean Perrin, Unité de Nutrition, CLARA, F-63000 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, UMR 1019, Unité de Nutrition Humaine, CRNH-Auvergne, BP 10448, F-63000 Clermont-Ferrand, France. Electronic address: M-paule.vasson@udamail.fr. 2. Clermont Université, Université d'Auvergne, UMR 1019, Unité de Nutrition Humaine, CRNH-Auvergne, BP 10448, F-63000 Clermont-Ferrand, France. 3. Centre Jean Perrin, Service d'Oncologie Médicale, F-63000 Clermont-Ferrand, France. 4. Centre Léon Bérard, Unité de Nutrition Clinique, F-69000 Lyon, France. 5. CHU Clermont-Ferrand, Service de Chirurgie Digestive, F-63003 Clermont-Ferrand, France. 6. CHU Clermont-Ferrand, Service de Médecine Digestive et Hépatobiliaire, F-63003 Clermont-Ferrand, France. 7. Centre Léon Bérard, Service de Radiothérapie, F-69000 Lyon, France. 8. CH Béziers, Service de Gastro-Entérologie, F-34500 Béziers, France. 9. Centre Jean Perrin, Service de Statistiques, F-63000 Clermont-Ferrand, France. 10. Clermont Université, Université d'Auvergne, UMR 1019, Unité de Nutrition Humaine, CRNH-Auvergne, BP 10448, F-63000 Clermont-Ferrand, France; CHU Clermont-Ferrand, Service de Médecine Digestive et Hépatobiliaire, F-63003 Clermont-Ferrand, France.
Abstract
BACKGROUND & AIMS: Malnutrition is frequent in head and neck (HN) and esophageal cancer patients and aggravated by radiochemotherapy (RCT), increasing morbi-mortality and treatment toxicity. Our goal was to investigate the effect of immunonutrition consisting of an arginine, omega-3 fatty acid, nucleotides-enriched diet on nutritional status, and functional capacity in HN or esophageal cancer patients undergoing RCT. METHODS:37 patients were randomized in a double-blind clinical trial. 5 days before and until the end of RCT (5-7 weeks), they received either an Immunomodulating Enteral Nutrition (IEN) or an isonitrogenous, isoenergetic Standard Enteral Nutrition (SEN). Anthropometrical parameters, nutritional risk index (NRI), serum albumin, plasma antioxidant capacity, and functional capacity were recorded between the beginning and the end of RCT. RESULTS: A significant gain in total body weight (+2.1 ± 3.1 kg) was observed in IEN patients. Albuminemia and NRI were improved concomitantly in IEN malnourished patients. Plasma antioxidant capacity was improved (+100 ± 13 μM EqTrolox) in IEN patients. Functional capacity measured by WHO Performance Status and Karnofsky index was maintained in IEN patients but significantly reduced in SEN patients. CONCLUSIONS: These preliminary data show that immunonutrition could improve the nutritional status together with functional capacity in HN and esophageal cancer patients undergoing RCT. CLINICAL TRIAL REGISTRATION: This clinical trial promoted by the University Hospital Center of Clermont-Ferrand has been registered at ClinicalTrial.gov website under the following reference: NCT00333099.
RCT Entities:
BACKGROUND & AIMS: Malnutrition is frequent in head and neck (HN) and esophageal cancerpatients and aggravated by radiochemotherapy (RCT), increasing morbi-mortality and treatment toxicity. Our goal was to investigate the effect of immunonutrition consisting of an arginine, omega-3 fatty acid, nucleotides-enriched diet on nutritional status, and functional capacity in HN or esophageal cancerpatients undergoing RCT. METHODS: 37 patients were randomized in a double-blind clinical trial. 5 days before and until the end of RCT (5-7 weeks), they received either an Immunomodulating Enteral Nutrition (IEN) or an isonitrogenous, isoenergetic Standard Enteral Nutrition (SEN). Anthropometrical parameters, nutritional risk index (NRI), serum albumin, plasma antioxidant capacity, and functional capacity were recorded between the beginning and the end of RCT. RESULTS: A significant gain in total body weight (+2.1 ± 3.1 kg) was observed in IEN patients. Albuminemia and NRI were improved concomitantly in IEN malnourished patients. Plasma antioxidant capacity was improved (+100 ± 13 μM EqTrolox) in IEN patients. Functional capacity measured by WHO Performance Status and Karnofsky index was maintained in IEN patients but significantly reduced in SEN patients. CONCLUSIONS: These preliminary data show that immunonutrition could improve the nutritional status together with functional capacity in HN and esophageal cancerpatients undergoing RCT. CLINICAL TRIAL REGISTRATION: This clinical trial promoted by the University Hospital Center of Clermont-Ferrand has been registered at ClinicalTrial.gov website under the following reference: NCT00333099.
Authors: Sanford M Dawsey; Renato B Fagundes; Brian C Jacobson; Laura A Kresty; Susan R Mallery; Shirley Paski; Piet A van den Brandt Journal: Ann N Y Acad Sci Date: 2014-09 Impact factor: 5.691
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