de Aguiar Pastore Silva Juliana, Emilia de Souza Fabre Maria, Waitzberg Dan Linetzky
Antonio Prudente Foundation, A. C. Camargo Cancer Center, São Paulo, Brazil.
Oncologic Research Center, Florianopolis, Santa Catarina, Brazil.
Clin Nutr. 2015 Jun;34(3):359-66. doi: 10.1016/j.clnu.2014.11.005. Epub 2014 Nov 14.
BACKGROUND & AIMS: Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), in vitro and in vivo, used along with anticancer drugs, have improved cancer treatment outcome. Clinical studies have reported positive results with omega-3 supplements in oncologic patients. We summarized only randomized controlled clinical trials involving the administration of DHA and/or EPA during chemotherapy and/or radiotherapy to assess the effects on treatment outcomes.
We conducted a systematic literature search using specific terms. Of 157 publications, 10 were selected on the basis of their methodological quality, according to the Oxford Quality Scale and the Cochrane Concealment Assessment. Outcome included body weight and composition, peripheral neuropathy, immune, inflammatory and oxidative status, quality of life, and membrane omega-3 fatty acids incorporation.
Treatment regimens included radiotherapy (1), chemotherapy (8), and chemoradiotherapy (1). The number of patients ranged from 11 to 92 and the daily dose of EPA and/or DHA from 600 mg to 3.6 g. For high quality methodology studies only, the combination of omega-3 fatty acids supplements with conventional chemotherapy was beneficial. None of the studies reported a worse outcome for the supplement patients.
There are beneficial effects of omega-3 fatty acids supplements in patients undergoing chemotherapy and/or radiotherapy on different outcomes, being the preservation of body composition the most evident. Some important outcome like decrease tumor size and prolonging patient survival, are not observed.
二十碳五烯酸(EPA)和二十二碳六烯酸(DHA)在体外和体内与抗癌药物联合使用时,可改善癌症治疗效果。临床研究报告了ω-3补充剂对肿瘤患者的积极效果。我们仅总结了在化疗和/或放疗期间给予DHA和/或EPA的随机对照临床试验,以评估其对治疗效果的影响。
我们使用特定术语进行了系统的文献检索。根据牛津质量量表和Cochrane隐匿性评估,从157篇出版物中筛选出10篇基于其方法学质量的文献。观察指标包括体重和身体成分、周围神经病变、免疫、炎症和氧化状态、生活质量以及细胞膜ω-3脂肪酸的掺入情况。
治疗方案包括放疗(1项)、化疗(8项)和放化疗(1项)。患者人数从11人到92人不等,EPA和/或DHA的每日剂量从600毫克到3.6克不等。仅对于高质量方法学研究,ω-3脂肪酸补充剂与传统化疗联合使用是有益的。没有研究报告补充剂组患者的结果更差。
ω-3脂肪酸补充剂对接受化疗和/或放疗的患者在不同结局方面有有益影响,其中对身体成分的保存最为明显。未观察到肿瘤大小减小和患者生存期延长等一些重要结局。