Bayram Ibrahim, Erbey Fatih, Celik Nilgun, Nelson Jeffrey L, Tanyeli Atila
Cukurova University Medical Faculty, Division of Pediatric Oncology, Adana, Turkey.
Pediatr Blood Cancer. 2009 May;52(5):571-4. doi: 10.1002/pbc.21852.
The aim of nutritional therapy in cancer patients is to prevent weight loss and to improve functional capacity and quality of life. Clinical studies however, have continued to demonstrate that a reduction in body weight loss is difficult to achieve in cancer cachexia. Several studies have shown that supplementation with eicosapentaenoic acid (EPA), an omega-3 fatty acid, has anti-cachectic effects in adult cancer patients. This study evaluated the clinical effects of a protein and energy dense EPA containing nutritional supplement in a group of pediatric cancer patients receiving active chemotherapy treatment.
The study was a prospective, randomized, single center, open-label design. Fifty-two patients diagnosed with pediatric malignant disease and receiving intensive chemotherapy were included. Thirty-three patients received a nutritional supplement containing EPA in addition to their regular food intake. Nineteen control patients did not receive supplementation. Patients were examined and their data (body weight, body mass index, and weight percentile) were recorded regularly once a month for 3 months. A subgroup of patients was evaluated for 6 months.
At 3 months, there were significantly fewer patients in the treatment group as compared to controls that showed losses in body weight (P = 0.001), BMI (P = 0.002), and a negative deviation in weight percentile (P = 0.021). In addition, remission rate was significantly (P = 0.036) higher in the treatment group as compared to controls.
This study demonstrates a decrease in cancer-induced weight loss in pediatric patients fed a protein and energy dense nutrition supplement containing EPA.
癌症患者营养治疗的目的是防止体重减轻，并改善功能能力和生活质量。然而，临床研究持续表明，在癌症恶病质患者中很难实现体重减轻的减少。多项研究表明，补充二十碳五烯酸（EPA），一种ω-3脂肪酸，对成年癌症患者有抗恶病质作用。本研究评估了一种含蛋白质和能量且富含EPA的营养补充剂对一组接受积极化疗的儿科癌症患者的临床效果。
该研究为前瞻性、随机、单中心、开放标签设计。纳入了52例被诊断为儿童恶性疾病并接受强化化疗的患者。33例患者在正常饮食之外还接受了含EPA的营养补充剂。19例对照患者未接受补充剂。对患者进行检查，并每月定期记录他们的数据（体重、体重指数和体重百分位数），持续3个月。对一组亚组患者进行了6个月的评估。
在3个月时，与对照组相比，治疗组中体重减轻、体重指数降低以及体重百分位数出现负偏差的患者明显更少（P = 0.001、P = 0.002、P = 0.021）。此外，与对照组相比，治疗组的缓解率显著更高（P = 0.036）。
本研究表明，给儿科患者喂食含蛋白质和能量且富含EPA的营养补充剂可减少癌症导致的体重减轻。
