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 100
- Downloads 0
Retention of pro-vitamin A carotenoid in composite bread baked with high quality cassava flour from yellow-fleshed cassava root
Background: As one of the most widely consumed foods, bread is one of the most important agricultural products. Bread made from high-quality cassava flour is consumed in some parts of Sub-Sahara Africa (SSA). The bread h...
Growth characteristics and total quality of MenthacordifoliaOpiz., kitchen mint as affected of Zn fortification
Background: Plant growth generally requires both macronutrients and micronutrients. One of the most important micronutrients for plants is zinc. Zinc is an essential nutrient for every life form, including plants. In par...
9-cis β-carotene Inhibits Atherosclerosis Development in Female LDLR-/- Mice
Background: Several epidemiological studies have shown that diets rich in carotenoids are associated with a reduced risk of cardiovascular disease. However, administration of synthetic all-trans b-carotene was reported t...
Preparation of function-enhanced vegetable oils
Background: Highly purified commercial vegetable oils, such as rape seed/canola oil, corn oil, safflower oil and soy bean oil have virtually no antioxidant activity against lipid peroxyl radical scavenging activi...
Accumulation of solvent-soluble and solvent-insoluble antioxidant phenolics in edible bean sprouts: implication of germination
Background: Edible bean sprouts are popular fresh vegetables widely recognized for their nutritional quality. However, while their antioxidant capacity and phenolic composition in both solvent-soluble and solvent-insolub...