Preventive effects of amino-acid-rich elemental diet Elental® on chemotherapy-induced oral mucositis in patients with colorectal cancer: a prospective pilot study.
Preventive effects of amino-acid-rich elemental diet Elental® on chemotherapy-induced oral mucositis in patients with colorectal cancer: a prospective pilot study.
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DOI：
10.1007/s00520-015-2844-0
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发表时间：
2016-02
期刊：
影响因子：
--
通讯作者：
Akagi Y
中科院分区：
文献类型：
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作者：
Ogata Y;Ishibashi N;Yamaguchi K;Uchida S;Kamei H;Nakayama G;Hirakawa H;Tanigawa M;Akagi Y
前瞻性初步研究旨在评价富含氨基酸的元素饮食（艾德）Elental®对结直肠癌患者化疗诱导的口腔粘膜炎的预防作用。并对其影响因素进行了探讨。共有22名合格的结直肠癌患者在接受氟尿嘧啶化疗期间出现1-3级口腔粘膜炎，进入本研究。他们的平均年龄是67岁。男10例，女12例。大多数患者的PS为0。患者在恢复至0级或1级口腔粘膜炎后同时接受两个疗程的相同化疗方案和Elental®。8例患者接受FOLFOX 6+贝伐珠单抗、8例患者接受FOLFIRI +贝伐珠单抗、1例患者接受FOLFIRI +帕尼单抗、1例患者接受FOLFIRI、2例患者接受XALIX+贝伐珠单抗和2例患者接受S-1 +西妥昔单抗作为一线（16例）或二线（6例）化疗。在2例达到3级口腔粘膜炎的患者和3例达到2级口腔粘膜炎的患者中，减少5-氟尿嘧啶（5-FU）或口服氟尿嘧啶的剂量。在Elental®的第一个疗程中，22名患者中有18名患者的口腔粘膜炎最高级别降低（p = 0.0002），在第二个疗程中，22名患者中有20名患者的口腔粘膜炎最高级别降低（p < 0.0001）。多变量分析发现，5-FU或口服氟嘧啶的剂量减少、艾德摄入量和既往给予艾德均是口腔粘膜炎预防疗效的重要因素。富含氨基酸的元素饮食Elental®可能是结直肠癌患者5-FU化疗诱导的口腔粘膜炎的有效对策。
The prospective pilot study was designed to evaluate the preventive effects of amino-acid-rich elemental diet (ED), Elental®, on chemotherapy-induced oral mucositis in patients with colorectal cancer. The factors influencing its efficacy are also investigated. A total of 22 eligible patients with colorectal cancer experiencing grade 1–3 oral mucositis during treatment with fluorouracil-based chemotherapy entered the current study. Their average age was 67 years. There were 10 male and 12 female. The PS was 0 in the majority of patients. Patients received two courses of the same chemotherapy regimen and Elental® concurrently after recovery to grade 0 or 1 oral mucositis. FOLFOX6 + bevacizumab in 8 patients, FOLFIRI + bevacizumab in 8 patients, FOLFIRI + panitumumab in 1 patient, FOLFIRI in 1 patient, XELOX + bevacizumab in 2 patients, and S-1 + cetuximab in 2 patients were used as first-line (16 cases) or as second-line (6 cases) chemotherapy. Dose reduction of 5-fluorouracil (5-FU) or oral fluoropyrimidine was performed in the 2 patients achieving grade 3 oral mucositis and in the 3 patients achieving grade 2 oral mucositis. The maximum grade of oral mucositis decreased in 18 of the 22 patients during the first treatment course with Elental® (p = 0.0002) and in 20 of the 22 patients in the second course (p < 0.0001). Multivariate analyses found that the dose reduction in 5-FU or oral fluoropyrimidine, ED intake, and the prior administration of ED were each a significant factor for the preventive efficacy on oral mucositis. The amino-acid-rich elemental diet Elental® may be useful as a countermeasure for 5-FU-based chemotherapy-induced oral mucositis in patients with colorectal cancer.