The amino acid-rich elemental diet Elental® preserves lean body mass during chemo- or chemoradiotherapy for esophageal cancer
The amino acid-rich elemental diet Elental® preserves lean body mass during chemo- or chemoradiotherapy for esophageal cancer
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DOI：
10.3892/or.2016.4877
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发表时间：
2016-08-01
期刊：
影响因子：
4.2
通讯作者：
Itoh, Yoshito
中科院分区：
文献类型：
--
作者：
Ishikawa, Takeshi;Yasuda, Tomoyo;Itoh, Yoshito
化疗（放化疗）可引起食管癌患者口腔黏膜炎，改变机体组成。富含氨基酸的元素饮食Elental (R)对口腔黏膜炎和化疗（放化疗）期间身体成分变化的影响尚不清楚。因此，本研究的目的是研究Elental对食管癌化疗（放化疗）期间口腔黏膜炎和肌肉减少症进展的预防作用。在治疗周期（4周）中，患者随机接受azulene口腔冲洗（第1组）或Elental（第2组）。每周评估口腔黏膜炎和其他不良事件的发生率。采用生物电阻抗法测定处理前后周期的体成分。33例患者（17例azulene， 16例Elental）完成了研究，两组匹配良好。元素有降低口腔黏膜炎发生率的趋势（第1组，23.5%，第2组，12.5%），但两组间差异无统计学意义。治疗后两组患者的平均体重指数（BMI）和体脂量均显著下降。治疗后，1组瘦体质量（LBM）降低，2组增加；治疗后LBM的相对变化组1与组2比较差异有统计学意义（P=0.007）。本研究显示，元素营养可以对抗食管癌放化疗期间肌肉减少症的发展。这些特性可能导致食管癌患者化疗（放化疗）治疗的生活质量和临床结果的改善（临床试验注册ID: UMIN 000007960）。
Chemo (chemoradio) therapy can induce oral mucositis and change body composition in patients with esophageal cancer. The impact of the amino acid-rich elemental diet Elental (R) on oral mucositis and changes in body composition during chemo (chemoradio) therapy is unclear. Thus, the purpose of the present study was to examine the preventive effects of Elental on oral mucositis and sarcopenia progression during chemo (chemoradio) therapy for esophageal cancer. Patients were randomized to receive either azulene oral rinse (Arm 1) or Elental (Arm 2) during the treatment cycle (4 weeks). The incidence of oral mucositis and other adverse events was evaluated weekly. Body composition pre- and post-treatment cycle was measured by bioelectric impedance analysis. Thirty-three patients (17 azulene and 16 Elental) completed the study, and the groups were well matched. Elental tended to reduce the incidence of oral mucositis (Arm 1, 23.5% and Arm 2, 12.5%), but there was no statistically significant difference between the groups. The average body mass index (BMI) and body fat mass decreased significantly in both groups after the treatments. Lean body mass (LBM) was reduced in Arm 1, but was increased in Arm 2 after the treatment; the relative change of LBM after the treatment was significant between Arm 1 and Arm 2 (P=0.007). This study revealed that Elental nutrition could counteract sarcopenia development during chemoradiotherapy for esophageal cancer. These properties may lead to improvement of the quality of life and clinical outcome of esophageal cancer patients treated with chemo (chemoradio) therapy (Clinical Trial Registry ID: UMIN 000007960).