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乳清蛋白在化疗的结直肠癌患者中的临床影响:一项安慰剂对照研究的初步结果。

Clinical Impact of Highly Purified, Whey Proteins in Patients Affected With Colorectal Cancer Undergoing Chemotherapy: Preliminary Results of a Placebo-Controlled Study.

机构信息

1 Sant'Andrea Hospital, University "La Sapienza," Rome, Italy.

2 Sapienza University, Rome, Italy.

出版信息

Integr Cancer Ther. 2019 Jan-Dec;18:1534735419866920. doi: 10.1177/1534735419866920.

Abstract

Sarcopenia, the loss of both lean body and skeletal muscle mass, may interfere in cancer patients outcome. As investigated, whey proteins could prevent the onset of sarcopenia. We have conducted a study to evaluate the effects of whey protein in colorectal cancer patients, undergoing 5-fluorouracil-based chemotherapy. After written informed consent, patients were blind randomized 1:1 to whey protein (ProLYOtin; arm A) versus placebo (arm B). The patients were assessed both physically and nutritionally before chemotherapy and after 3 (T2) and 6 months (T3) by body impedance assessment, L3-computed tomography scan, Mini Nutritional Assessment (MNA), and Malnutrition Universal Screening Tool (MUST) tests. Forty-seven patients were included in this preliminary analysis. Baseline characteristics were well balanced between the 2 arms. During chemotherapy, 33 patients were reevaluated: anthropometric parameters (lean body mass from 68.5% to 71.2% vs 68.7% to 66.3%, and sarcopenia from 84% to 54% and 83% to 77% from baseline to T2 evaluation in arms A and B, respectively), nutritional status (MNA >24 = 100% [A] vs 73.7% [B]), and toxicity (no adverse effects in 86% [A] vs 29% [B] and 94% [A] vs 29% [B] for hematological and gastrointestinal toxicities, respectively) resulted to be significantly different. At univariate analysis, a condition of malnutrition risk according to MUST (relative risk [RR] = 7.5, = .02) or MNA (RR = 1.45, = .02) and ProLYOtin intake (RR = 0.12, = .01) were found to be significantly predictive of chemotherapy toxicity. At present, our study shows how whey protein could be an important therapeutic option to improve nutritional status, and particularly to prevent severe toxicity during chemotherapy.

摘要

肌肉减少症,即去脂体重和骨骼肌质量的双重损失,可能会影响癌症患者的预后。研究表明,乳清蛋白可以预防肌肉减少症的发生。我们进行了一项研究,评估了乳清蛋白对接受基于氟尿嘧啶的化疗的结直肠癌患者的影响。在书面知情同意后,患者以 1:1 的比例盲法随机分为乳清蛋白(ProLYOtin;A 组)与安慰剂(B 组)。患者在化疗前和化疗后 3 个月(T2)和 6 个月(T3)进行身体和营养评估,通过身体阻抗评估、L3 计算机断层扫描、微型营养评估(MNA)和营养不良通用筛查工具(MUST)进行测试。共有 47 名患者纳入本初步分析。两组患者的基线特征平衡良好。在化疗期间,对 33 名患者进行了重新评估:人体测量参数(瘦体重从 68.5%降至 71.2%比 68.7%降至 66.3%,肌肉减少症从 84%降至 54%和 83%降至 77%,从基线到 T2 评估在 A 组和 B 组),营养状况(MNA>24=100%[A]比 73.7%[B])和毒性(A 组无不良反应的比例为 86%[A]比 29%[B],B 组血液学和胃肠道毒性分别为 94%[A]比 29%[B])结果差异显著。单因素分析发现,根据 MUST(相对风险[RR]=7.5,.02)或 MNA(RR=1.45,.02)和 ProLYOtin 摄入(RR=0.12,.01)评估存在营养不良风险的情况与化疗毒性显著相关。目前,我们的研究表明,乳清蛋白可能是一种重要的治疗选择,可以改善营养状况,特别是预防化疗期间的严重毒性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8661/6681246/019e880dadc2/10.1177_1534735419866920-fig1.jpg

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