PhilSPEN Online Journal of Parenteral and Enteral Nutrition

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(Article 84 | POJ_0078)

Submitted Abstracts

PENSA 2017 Congress

Submitted: August 14, 2017

Abstract ID = 48 | Classification: (4) - Disease specific nutrition issues

Title: Applications of enteral Omega-3 polyunsaturated fatty acids during the treatment of GI cancers: a systematic review of RCTs

Author(s): Chen MJ, Wang TE, Chu CH, Lin YS, Chang CW

Institution where study was conducted: Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital and MacKay Medical College, Taipei, Taiwan

Keywords: "Omega-3”, “DHA”, “EPA”, “gastrointestinal”, “cancer”, "chemo/radiotherapy", "operation"

Background: In clinical settings, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have been reported to improve the immune response, maintain lean body mass, improve quality of life survival in patients with UGI cancer during treatment.

Objectives: The aim of this systematic review was to determine the efficacy and potential benefits of enteral Omega-3 during the treatment of GI cancers.

Methods: A literature research was conducted by combining the keywords “Omega-3” “DHA”, “EPA”, with the keywords “gastrointestinal”, “stomach”, “esophagus”, “colon” or “pancreas” and “cancer” or “neoplasm”. Restrictions comprised English language publications during the time period January 1990 to June 2017. All studies were used any form of enteral EPA or DHA (capsules or enriched ONS; oral or tube feeding). We summarized only randomized controlled trials involving the administration of Omega-3, fish oil and EPA or/and DHA during treatment modality (chemo/radiotherapy or peri-operation) to assess the effects on treatment outcomes from the control. Outcome included body weight and composition, white blood cell count, serum albumin, lymphocytes, inflammatory and oxidative status, quality of life and overall survival.

Results: This systemic review summarized the clinical studies reporting the use of Omega-3 enriched nutrition or fish oil in the peri-operation setting (17 studies) and the use of EPA/DHA in chemotherapy/ radiation settings (10 studies), respectively. Enteral supplementation of Omega-3 or fish oil has been described in the peri-operative setting (17 studies) included heterogeneous groups of patients with different GI cancer types. The following observations were found: Omega-3 polyunsaturated fatty acids improved immune response, decreased C-reactive protein, lower complication rate, shorter hospital stay and decreased IL-6, IL-8 and TNF-a levels. In the chemotherapy/ radiation settings (10 studies), studies showed EPA/DHA supplement improved chemotherapy tolerability, quality of life and preservation of body weight.

Conclusion: There are beneficial effects of Omega-3 supplements in patients with GI cancers undergoing chemotherapy/radiotherapy or surgery, the preservation of body composition is the most evident. The progression outcome likes decrease tumor size and prolonging patient survival, however are not observed.