PhilSPEN Online Journal of Parenteral and Enteral Nutrition

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(Article 70 | POJ_0064)

Submitted Abstracts

PENSA 2017 Congress

Submitted: July 7, 2017

Abstract ID = 33 | Classification: 4

Title: Immune-enhanced nutritional intervention in cancer patients treated with concurrent chemoradiotherapy

Author(s): Chitapanarux I (1,2,3), Pisprasert V (4), Chitapanarux T (5), Chakrabhandu S (1,2), Jiratrachu R (6), Chottaweesak P (7), Rasio W (7), Sripan P (1,2,3), Traisathit P (8)

Institution where study was conducted:

  1. Division of Radiation Oncology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  2. Northern Thai Research Group of Radiation Oncology (NTRG-RO), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  3. Chiang Mai Cancer Registry, Maharaj Nakorn Chiang Mai Hospital, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  4. Division of Nutrition, Faculty of Medicine, Khon Kaen University, Thailand
  5. Division of Gastroenterology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  6. Division of Radiation Oncology, Faculty of Medicine, Songklanagarind , Songkla, Thailand
  7. Radiotherapy unit, Radiology Department, Maharat Nakhon Ratchasima Hospital, Maharat Nakhon Ratchasima, Thailand
  8. Department of Statistics, Faculty of Science, Chiang Mai University, Thailand

Keywords: immune-enhanced nutrition, concurrent chemoradiotherapy, cancer

Background: Concurrent chemoradiotherapy (CCRT) is widely used in the treatment of solid tumors. Toxicities of two modalities lead to unplanned treatment break and incomplete treatment protocol, which has been associated with the poor treatment outcome.

Objectives: We evaluated the efficacy of immune-enhanced nutritional supplement in patients’ ability to adhere to the planned regimen and associated toxicities in cancer patients who received CCRT.

Methods: Eighty-eight cancer patients who treated with CCRT were randomized to group A (n = 44); receiving a regular diet and group B (n = 44); receiving a regular diet plus immune-enhanced nutrition supplements during CCRT.

Results: Forty patients (45.5%) were head and neck cancer, 28 patients (31.8%) were esophageal cancer, and 20 patients (22.7%) were cervical cancer. Grade 3-4 hematologic toxicities were significantly difference; 20.8% and 4.6% in group A and B, respectively (p=0.03). For grade 3-4 non-hematologic toxicities, 11.4% in group A had mucositis and dermatitis but only 2.3% in group B developed mucositis, which was not significantly difference (p = 0.20). The CCRT completion rate in group A patients were lower than group B (75% versus 91%) with no statistically difference (p = 0.09). Adjusted for primary tumor and age, immune-enhanced nutrition supplement (p = 0.04) were associated with lower hematologic toxicities.

Conclusion: Immune-enhanced nutrition supplement during CCRT reduced the incidence of severe hematological toxicities and enabled more cancer patients to stay on their treatment plan.