Randomized study of nutritional status and treatment toxicities of oral arginine, glutamine, and Omega-3 fatty acids during concurrent chemoradiotherapy for head and neck cancer patients
Journal Title: Functional Foods in Health and Disease - Year 2016, Vol 6, Issue 3
Abstract
Background: Patients with head and neck cancer (HNC) undergoing concurrent chemoradiotherapy (CCRT) are at high risk of dysphagia, malnutrition, and immunosuppression. Arginine, glutamine, and Omega-3 fatty acidsare immune-enhanced nutrition that can promote cellular immunity.We aimed to examine the impact of immunonutrition diet on nutritional status, and CCRT toxicities, in this group of patients. Methods: Forty patients with HNC who treated with curative CCRT were randomized to: group A (n = 20), patients who received a regular diet and dietary counselingby a protocol dietician; group B (n = 20), patients who received a regular diet plus immune-enhanced nutrition supplements and dietary counseling by the same protocol dietician. Outcome measures were weight loss, protein and energy intake, serum pre-albumin and albumin, and toxicities of CCRT were evaluated at baseline, weekly and at the end of treatment. Results:Both groups were well balanced at baseline.One patient from group A (1/20) withdrew consent. Seven patients from group B (7/20) withdrew from the study; 1 patient could not tolerate the side effect of chemotherapy and 6 patients could not tolerate the taste of oral immune-enhanced nutrition.A significant loss in total body weight was observed in group A patients (p<0.001), whereas not significant loss in group B (p=0.109). Median percentage change from baseline of energy intake was 19.6%, and 22.9% at the end of treatment for group A, and B, respectively. The circulating levels of nutritional markers, pre-albumin and albumin decreased after CCRT in both groups. There was a significantly decreased level of albumin in group A more than group B, at the end of treatment. During CCRT; 4 patients (20%) in group A and 1 patient(5%) in group B developed grade 3 mucositis, respectively. One patient (5%) in group A had grade 3 radiation dermatitis. Grade 3 – 4 hematologic toxicities, mainly in absolute neutrophil count (ANC) were significant higher in group A than group B; 20% versus 0% (p=0.035).Over the 7-week period of CCRT, both intention to treat analysis and per protocol analysis revealed similar in scaled for all endpoints. Conclusions: Nutritional counseling and immuno-nutrition can reduce the deterioration of nutrition status and also significantly reduced hematologic and non-hematologic toxicity of CCRT in head and neck cancer.
Authors and Affiliations
Imjai Chitapanarux, Veeradej Pisprasert, Ekkasit Tharavichitkul, Somvilai Jakrabhandu, Pitchayaponne Klunklin, Wimrak Onchan, Bongkot Supawongwattana, Patrinee Traisathit, Sornvichate Rattanachaiwong, Witiya M Sattasiri
Keywords
Related Articles
- EP ID EP449257
- DOI 10.31989/ffhd.v6i3.230
- Views 96
- Downloads 0
Functional quality, sensorial and shelf life characteristics of Agathi (Sesbania grandiflora (L).Poir leaves enriched breads
Background: In our modern life burden of non-communicable diseases such as obesity, cancer, cardio vascular disease and type-2 diabetes has increased. By contrast, life expectancy and also cost of health care has increas...
Health Benefits of Dietary Tree Peony Seed Oil in a High Fat Diet Hamster Model
Background: Tree peony (Paeonia ostii) seed oil is rich in different unsaturated fatty acids, including monounsaturated fatty acids (MUFA), n-3 and n-6 polyunsaturated fatty acids (PUFA). Health benefits of this edible p...
Effects of Namya Kanom Jeen powder extracts on anti-oxidative and anti-inflammatory properties
Background: Spices and herbs are known to have anti-oxidant and anti-inflammatory properties. We studied their properties of Namya Kanom Jeen (NKJ), a spicy soup (Southern Thailand recipe) with water and ethanol (50% and...
The effects of bioactive compounds on Alzheimer’s disease and mild cognitive impairment
Prevalence rates of Alzheimer’s disease are increasing in countries around world, and identifying effective treatments to manage cognitive impairment and neurodegeneration has become a global health priority. Decades of...
Astaxanthin attenuates neurotoxicity in a mouse model of Parkinson’s disease
Background: Astaxanthin (AXT) is a natural carotenoid with diverse biological activities. Although it is best known as a potent antioxidant, recent work suggests additional mechanisms of action that have the potential to...