Randomized study of clinical effect of enteral nutrition support during neoadjuvant chemotherapy on chemotherapy-related toxicity in patients with esophageal cancer

Clin Nutr. 2012 Jun;31(3):330-6. doi: 10.1016/j.clnu.2011.11.002. Epub 2011 Dec 12.

Abstract

Background & aims: Enteral nutrition (EN) is provided for patients with cancer. However, Little is known about the clinical efficacy of EN support during chemotherapy in patients with cancer.

Methods: Ninety-one patients who received neoadjuvant chemotherapy (5-fluorouracil, cisplatin and adriamycin) for esophageal cancer were enrolled to receive either EN (n = 47) or PN (n = 44) at random. The primary endpoint was the incidence of chemotherapy-related toxicities during chemotherapy.

Results: Total and dietary intake calories during chemotherapy were equal in the two groups. There were no significant differences in serum albumin level and body weight change after chemotherapy between the two groups. There was no significant difference in tumor response to chemotherapy between the two groups (EN: 51%, PN: 55%, p = 0.886). Leukopenia and neutropenia of grade 3 or 4, defined according to the Common Toxicities Criteria of the National Cancer Institute, were significantly less frequent in the EN group than PN group (leukopenia: 17% vs 41%, p = 0.011, neutropenia: 36% vs 66%, p = 0.005). Lymphopenia and thrombocytopenia tended to be less frequent in the EN group, albeit insignificantly.

Conclusions: Compared with PN support, EN support during neoadjuvant chemotherapy reduced the incidence of chemotherapy-related hematological toxicities in patients with esophageal cancers.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Cisplatin / adverse effects
  • Cisplatin / therapeutic use
  • Dietary Supplements / adverse effects
  • Dietary Supplements / analysis
  • Doxorubicin / adverse effects
  • Doxorubicin / therapeutic use
  • Enteral Nutrition* / adverse effects
  • Esophageal Neoplasms / blood
  • Esophageal Neoplasms / drug therapy*
  • Esophageal Neoplasms / pathology
  • Esophageal Neoplasms / therapy
  • Fatty Acids, Omega-3 / administration & dosage
  • Fatty Acids, Omega-3 / blood
  • Fatty Acids, Omega-3 / therapeutic use
  • Female
  • Fluorouracil / adverse effects
  • Fluorouracil / therapeutic use
  • Humans
  • Incidence
  • Japan / epidemiology
  • Leukopenia / chemically induced
  • Leukopenia / epidemiology
  • Leukopenia / prevention & control*
  • Male
  • Middle Aged
  • Neoadjuvant Therapy / adverse effects*
  • Neoplasm Staging
  • Neutropenia / chemically induced
  • Neutropenia / epidemiology
  • Neutropenia / prevention & control*
  • Patient Compliance

Substances

  • Antineoplastic Agents
  • Fatty Acids, Omega-3
  • Doxorubicin
  • Cisplatin
  • Fluorouracil