- 期刊
ω-3脂肪酸對於接受同步性化學放射治療食道癌病人營養狀態之影響—前導型研究
The Impact of ω-3 Fatty Acid on the Nutritional Status of Esophageal Cancer Patients Undergoing Concurrent Chemoradiotherapy-pilot study
摘要
與其他消化道癌症相比，有70%食道癌病人新診斷時已發生營養不良，研究指出食道癌病人接受同步性化學放射治療期間，體重若下降超過10%，其死亡率增加2倍，顯示給予食道癌病人營養支持是重要的。許多研究發現給予癌症病人使用含ω-3脂肪酸之配方，例如docosahexaenoic acid（DHA）和eicosapentaenoic acid（EPA），對於腫瘤惡病質有正面改善的幫助，或可能可逆轉或阻止惡病質的發展，這對癌症病人的營養狀況有積極的影響。本研究目的為觀察食道癌病人是否補充富含ω-3脂肪酸之配方，對其身體組成及營養狀況之影響。我們以隨機試驗方式，招募10位食道癌病人，並隨機分為兩組，在接受同步性化學放射治療期間，分別給予使用含ω-3脂肪酸配方（實驗組）及一般均衡配方（對照組），觀察體重、營養狀況、生活品質與血液生化數值之變化。研究結果顯示兩組（實驗組vs.對照組）在營養支持後，前後體重差異之中位數為-1.50 kg vs. -1.80 kg，小腿圍之中位數差異為-0.50 cm vs. < 0.01 cm，中臂圍之中位數差異為-1.00 cm vs. -1.30 cm。白蛋白之中位數差異為-0.20 mg/mL vs. -0.40 mg/mL，血紅素之中位數差異為-2.60 g/dL vs. -2.80 g/dL，C-reactive protein（CRP）之中位數差異為-0.12 mg/dL vs. 0.15 mg/dL。本試驗發現實驗組體重、中臂圍、白蛋白與血紅素之中位數下降程度低於對照組，且實驗組CRP之中位數上升幅度低於對照組，但因收案人數太少，未來希望可再多觀察更多受試者的營養變化，期望給予治療中的病人，更多營養支持選擇。
並列摘要
Compared with other gastrointestinal cancers, 70% of patients who are newly diagnosed with esophageal cancer are malnourished. In addition, the mortality rate of patients with esophageal cancer undergoing concurrent chemoradiotherapy would double if these patients experience weight loss of more than 10%. These findings indicate the importance of nutritional support in patients with esophageal cancer. Many studies have revealed that patients with cancer who are administered formulations containing ω-3 fatty acids (i.e., docosahexaenoic and eicosapentaenoic acids) show positive improvements in cancer cachexia, potentially reversing or preventing its development/progression; this has a favorable impact on the nutritional status of these patients. The aim of this study was to investigate the influence of enteral nutrition enriched with ω-3 fatty acids on body composition and nutritional status. In this randomized trial, we recruited 10 patients with esophageal cancer who were randomly assigned to two groups. During concurrent chemoradiotherapy, one group received a formulation containing ω-3 fatty acids (experimental group), whereas the other group received a standard balanced formulation (control group). Changes in body weight, nutritional status, quality of life, and blood biochemical values were monitored. The results showed that the median body weight differences between the two groups (experimental group vs. control group) of -1.50 kg vs. -1.80 kg. The median differences in calf circumferences between the two groups of -0.50 cm vs. < 0.01 cm. The median differences in mid-arm circumference between the two groups were -1.00 cm vs. -1.30 cm. The median differences in albumin between the two groups were -0.20 mg/mL vs. -0.40 mg/mL. The median differences in hemoglobin between the two groups were -2.60 g/dL vs. -2.80 g/dL. The median differences in C-reactive protein (CRP) between the two groups were -0.12 mg/dL vs. 0.15 mg/dL. Our results revealed that the median weight, mid-arm circumference, albumin, and hemoglobin decreased less in the experimental group than in the control group, while the median CRP increased less in the experimental group than in the control group. This finding may be due to the small number of study participants. In future studies, further observations with a larger sample size are warranted to monitor changes in nutritional status and thus provide more nutritional support options for patients with cancer during treatment.