NEW YORK (Reuters Health) – For patients with head and neck or esophageal cancer undergoing chemoradiotherapy, enteral nutrition enriched with n-3 fatty acids helps preserve body mass.

The finding comes from a randomized controlled trial conducted in Germany. It also indicated that such nutritional support may also improve tolerance to chemoradiotherapy.

Dr. Dorota Lubgan, with Erlangen University Hospital, and colleagues explain in the journal Cancer online June 13 that patients with head and neck or esophageal cancer are prone to cachexia, and nutritional status is likely to deteriorate further during concurrent chemotherapy and radiotherapy.

Because n-3 fatty acids have been shown to counter mediators of tumor cachexia, the team assessed the effects of enteral nutrition rich in eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in this setting. For the double-blind trial, 111 patients undergoing chemoradiotherapy (CRT) – 102 with head and neck cancer, 9 with esophageal carcinoma — were randomized to receive the experimental formula or standard enteral nutrition administered via percutaneous endoscopic gastrostomy.

At 7 weeks after completion of treatment, there was less body cell mass loss with the EPA/DHA formula (-0.82 kg) than with the standard formula (-2.82 kg), although the difference was of borderline significance (p=0.055).

While there was a similar trend in other nutritional parameters such as BMI and skin-fold thickness, differences were not significant, the team found. Subjective parameters, on the other hand, improved significantly in the experimental group, especially in terms of the Kondrup score (p=0.0165).

“Enteral nutrition with EPA and DHA may be advantageous in patients with head and neck or esophageal cancer by improving parameters of nutritional and functional status during CRT,” the authors concluded.

The incidence of adverse events(AEs) probably related to nutritional therapy was 10.9% in the experimental group compared to 25.0% in the control group, which fell just short of statistical significance (p=0.0535). The difference in incidence of AEs related to treatment, however, was not statistically significant (p=0.093).

Nonetheless, Dr. Lubgan and colleagues commented, “The rate of AEs related to study CRT was distinctly lower in patients treated with experimental nutrition than in controls, as were the rate of premature discontinuations due to AEs or adverse drug reactions and the rate of AEs suspected to be related to CRT, suggesting that the application of the experimental nutritional therapy may also be associated with a better tolerance of CRT.”

SOURCE: A disease-specific enteral nutrition formula improves nutritional status and functional performance in patients with head and neck and esophageal cancer undergoing chemoradiotherapy: Results of a randomized, controlled, multicenter trial
Cancer 2013.