title: Randomized study of clinical effect of enteral nutrition support during neoadjuvant chemotherapy on chemotherapy-related toxicity in patients with esophageal cancer.
abstract: OBJECTIVE
  Enteral nutrition (EN) is provided for patients with cancer. However, Little is known about the clinical efficacy of EN support during chemotherapy in patients with cancer.
  
  
  METHODS
  Ninety-one patients who received neoadjuvant chemotherapy (5-fluorouracil, cisplatin and adriamycin) for esophageal cancer were enrolled to receive either EN (n = 47) or PN (n = 44) at random. The primary endpoint was the incidence of chemotherapy-related toxicities during chemotherapy.
  
  
  RESULTS
  Total and dietary intake calories during chemotherapy were equal in the two groups. There were no significant differences in serum albumin level and body weight change after chemotherapy between the two groups. There was no significant difference in tumor response to chemotherapy between the two groups (EN: 51%, PN: 55%, p = 0.886). Leukopenia and neutropenia of grade 3 or 4, defined according to the Common Toxicities Criteria of the National Cancer Institute, were significantly less frequent in the EN group than PN group (leukopenia: 17% vs 41%, p = 0.011, neutropenia: 36% vs 66%, p = 0.005). Lymphopenia and thrombocytopenia tended to be less frequent in the EN group, albeit insignificantly.
  
  
  CONCLUSIONS
  Compared with PN support, EN support during neoadjuvant chemotherapy reduced the incidence of chemotherapy-related hematological toxicities in patients with esophageal cancers.
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan. hmiyata@gesrug.med.osaka-u.ac.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Miyata
authors.forename: Masahiko
authors.initials: M
authors.lastname: Yano
authors.forename: Takushi
authors.initials: T
authors.lastname: Yasuda
authors.forename: Rie
authors.initials: R
authors.lastname: Hamano
authors.forename: Makoto
authors.initials: M
authors.lastname: Yamasaki
authors.forename: Eihou
authors.initials: E
authors.lastname: Hou
authors.forename: Masaaki
authors.initials: M
authors.lastname: Motoori
authors.forename: Osamu
authors.initials: O
authors.lastname: Shiraishi
authors.forename: Koji
authors.initials: K
authors.lastname: Tanaka
authors.forename: Masaki
authors.initials: M
authors.lastname: Mori
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Doki
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D002945:Cisplatin / Q000009:adverse effects / Q000627:therapeutic use; D019587:Dietary Supplements / Q000009:adverse effects / Q000032:analysis; D004317:Doxorubicin / Q000009:adverse effects / Q000627:therapeutic use; D004750:Enteral Nutrition / Q000009:adverse effects; D004938:Esophageal Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000473:pathology / Q000628:therapy; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use; D005260:Female; D005472:Fluorouracil / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D007970:Leukopenia / Q000139:chemically induced / Q000453:epidemiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000009:adverse effects*; D009367:Neoplasm Staging; D009503:Neutropenia / Q000139:chemically induced / Q000453:epidemiology / Q000517:prevention & control*; D010349:Patient Compliance
chemical_list: D000970:Antineoplastic Agents; D015525:Fatty Acids, Omega-3; D004317:Doxorubicin; D002945:Cisplatin; D005472:Fluorouracil