Medical nutrition therapy versus standard nutrition advice in patients with esophageal cancer: effect on inflammatory cytokines and nutritional status
摘要
Malnutrition is common in patients with esophageal cancer. The purpose of this study was to compare medical nutrition therapy (MNT) with standard nutritional advice (NA) regarding nutritional status and serum cytokine levels in patients during chemoradiation therapy (CRT).
MethodsNewly diagnosed esophageal cancer patients were included. The MNT group (n = 30) received individualized nutritional consultation as well as oral nutritional supplements from an experienced nutritionist during 4–6 weeks of CRT. The NA group (n = 30) was provided only with standardized dietary advice. The primary endpoints were Patient-Generated Subjective Global Assessment (PG-SGA) and weight. The secondary endpoints were anthropometric indices, body composition, dietary intake, nutrition-related complications, and serum concentrations of IL-1β, IL-6, IL-8, and MCP-1. The patients were assessed before, immediately after, and 4–6 weeks following the treatment.
ResultsMNT group had a significantly higher total energy (29.1 ± 13 vs. 18.4 ± 9 kcal per kg of weight per day) (P = 0.001) and protein (1.08 ± 0.5 vs. 0.67 ± 0.4 g per kg of weight per day) intake than the NA group (P = 0.003). A non-significant drop in the PG-SGA score was observed in both groups during the treatment. Weight, MUAC, body composition, physical performance, nutrition-related complications, and the levels of the cytokines were not significantly different between the two groups at any point. There was also no significant difference in 12-month survival between the two groups.
ConclusionDespite significantly higher total daily energy and protein intake in the MNT group, there was no significant difference in nutritional status indices and inflammatory cytokine levels between MNT and NA groups immediately after and 4–6 weeks following CRT.