title: N-3 fatty acids, cancer and cachexia: a systematic review of the literature.
abstract: Use of n-3 fatty acids (FA) has been reported to be beneficial for cancer patients. We performed a systematic review of the literature in order to issue recommendations on the clinical use of n-3 FA in the cancer setting. A systematic search was performed in MEDLINE, EMBASE, Cochrane and Healthstar databases. We selected clinical trials or prospective observational studies including patients with cancer and life expectancy >2 months, in which enteral supplements with n-3 FA were administered. Parameters evaluated individually were clinical (nutritional status, tolerance, survival and hospital stays), biochemical (inflammatory mediators), and functional (functional status, appetite and quality of life (QoL)). Seventeen studies met the inclusion criteria; eight were of high quality. The panel of experts established the following evidence: (1) oral supplements with n-3 FA benefit patients with advanced cancer and weight loss, and are indicated in tumours of the upper digestive tract and pancreas; (2) the advantages observed were: increased weight and appetite, improved QoL, and reduced post-surgical morbidity; (3) there is no defined pattern for combining different n-3 FA, and it is recommended to administer > 1.5 g/day; and (4) better tolerance is obtained administering low-fat formulas for a period of at least 8 weeks. All the evidences were grade B but for 'length of treatment' and 'advantage of survival' it was grade C. Our findings suggest that administration of n-3 FA (EPA and DHA) in doses of at least 1.5 g/day for a prolonged period of time to patients with advanced cancer is associated with an improvement in clinical, biological and QoL parameters.
authors.affiliation: Medical Oncology Service, Catalan Institute of Oncology, Girona, Spain. rcolomer@icogirona.scs.es
authors.forename: Ramón
authors.initials: R
authors.lastname: Colomer
authors.forename: José M
authors.initials: JM
authors.lastname: Moreno-Nogueira
authors.forename: Pedro P
authors.initials: PP
authors.lastname: García-Luna
authors.forename: Pilar
authors.initials: P
authors.lastname: García-Peris
authors.forename: Abelardo
authors.initials: A
authors.lastname: García-de-Lorenzo
authors.forename: Antonio
authors.initials: A
authors.lastname: Zarazaga
authors.forename: Luis
authors.initials: L
authors.lastname: Quecedo
authors.forename: Juan
authors.initials: J
authors.lastname: del Llano
authors.forename: Luis
authors.initials: L
authors.lastname: Usán
authors.forename: César
authors.initials: C
authors.lastname: Casimiro
mesh_terms: D002100:Cachexia / Q000517:prevention & control; D019587:Dietary Supplements; D004067:Digestive System Neoplasms / Q000401:mortality / Q000517:prevention & control*; D015118:Eicosapentaenoic Acid / Q000008:administration & dosage / Q000009:adverse effects; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D017410:Practice Guidelines as Topic; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015525:Fatty Acids, Omega-3; D015118:Eicosapentaenoic Acid