Department of Palliative Medicine, University Hospital, RWTH Aachen, Germany.
Palliat Med. 2012 Jun;26(4):294-304. doi: 10.1177/0269216311418709. Epub 2011 Aug 24.
The European Palliative Care Research Collaboration is developing clinical guidelines on cachexia in patients with advanced cancer. A systematic review on the use of fish oil/omega-3-fatty acids (n-3-FA)/eicosapentaenoic acids (EPA) in advanced cancer patients suffering from cancer cachexia was performed as part of the guideline development.
The systematic literature search in Medline on the use of fish oil/n-3-FA/EPA identified 244 papers, with 38 publications included in the final evaluation. Some smaller trials, often unrandomized and without a control group, reported a good effect of n-3-FA in patients with advanced cancer and cachexia. However, the results of the larger randomized controlled trials could not support the positive results, as they mostly did not find a significant effect.
Adverse effects such as abdominal discomfort, fish belching, fish aftertaste, nausea and diarrhoea were reported with a low incidence. No serious adverse effects were documented, but adverse effects often had an impact on quality of life. This often limited dose escalations or even led to discontinuation of n-3-FA.
There is not enough evidence to support a net benefit of n-3-FA in cachexia in advanced cancer. On the other hand, adverse effects were infrequent, with no severe adverse effects. The results from the review led to a weak negative GRADE recommendation.
欧洲姑息治疗研究协作组织正在制定关于晚期癌症患者恶病质的临床指南。作为指南制定的一部分，对鱼油/ω-3 脂肪酸（n-3-FA）/二十碳五烯酸（EPA）在患有癌症恶病质的晚期癌症患者中的应用进行了系统评价。
在 Medline 上对鱼油/n-3-FA/EPA 的使用进行了系统的文献检索，共确定了 244 篇论文，其中 38 篇被纳入最终评估。一些规模较小的试验，通常是非随机的，没有对照组，报告了 n-3-FA 对晚期癌症和恶病质患者的良好效果。然而，较大规模的随机对照试验的结果并不能支持这些积极的结果，因为它们大多没有发现显著的效果。
报告了一些不良反应，如腹部不适、鱼嗝、鱼腥味、恶心和腹泻，但发生率较低。没有记录到严重的不良反应，但不良反应往往会影响生活质量。这通常会限制剂量的增加，甚至导致 n-3-FA 的停药。
没有足够的证据支持 n-3-FA 在晚期癌症恶病质中的净获益。另一方面，不良反应不常见，也没有严重的不良反应。该综述的结果导致了一个弱的负面 GRADE 推荐。
