Improved nutritional support with immune-modulating formula in patients with head and neck and esophageal cancer...

Malnutrition is frequent in patients with head and neck (HN) and esophageal cancer, aggravated by radiochemotherapy (RCT), and increases morbidity and mortality and treatment toxicity. Recent studies suggest that the immune, nutritional, or inflammatory status can be modulated by the use of pharmaconutrients in RCT-treated patients. In this study, the effect of immunonutrition, including arginine, ω-3 fatty acid, and nucleotide enriched diet, on nutritional status in patients with HN or esophageal cancer undergoing RCT was investigated.

A retrospective review of 88 patients undergoing RCT was conducted. Either an immune-modulating enteral nutrition (IEN) (Impact formula) or a standard enteral nutrition (SEN) (isonitrogenous and isoenergetic formula) was administered. Anthropometric parameters, nutritional risk index (NRI), serum albumin, and functional capacity were recorded at the beginning and end of the RCT.

Approximately 45% of patients were moderate to severely malnourished (NRI <97.5) at the beginning of the RCT in the SEN (n=19) and IEN (n=21) groups alike. Significant improvement was observed in the NRI of malnourished patients of the IEN group (97.3±11.9 vs 98.0±12.0, p=0.021). Additionally, a significant difference in the body weight (BW) between the two groups was observed, and BW increased (65.4±14.8 kg vs 66.3±14.3 kg, p=0.03) in the IEM group but decreased (62.3±12.3 kg vs 61.7±12.0 kg, p=0.023) in the SEM group.

Pharmaconutrient- enriched IEN had a more potent effect than SEN in preventing deterioration of nutritional status during RCT.