title: A disease-specific enteral nutrition formula improves nutritional status and functional performance in patients with head and neck and esophageal cancer undergoing chemoradiotherapy: results of a randomized, controlled, multicenter trial.
abstract: BACKGROUND
  In patients with head and neck and esophageal tumors, nutritional status may deteriorate during concurrent chemoradiotherapy (CRT). The aim of this study was to investigate the influence of enteral nutrition enriched with eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) on body composition and nutritional and functional status.
  
  
  METHODS
  In a controlled, randomized, prospective, double-blind, multicenter study, 111 patients with head and neck and esophageal cancer undergoing concurrent CRT received either an enteral standard nutrition (control group) or disease-specific enteral nutrition Supportan®-containing EPA+DHA (experimental group) via percutaneous endoscopic gastrostomy. The primary endpoint was the change of body cell mass (BCM) following CRT at weeks 7 and 14 compared with the baseline value. Secondary endpoints were additional parameters of body composition, anthropometric parameters, and nutritional and functional status.
  
  
  RESULTS
  The primary endpoint of the study, improvement in BCM, reached borderline statistical significance. Following CRT, patients with experimental nutrition lost only 0.82 ± 0.64 kg of BCM compared with 2.82 ± 0.77 kg in the control group (P = .055). The objectively measured nutritional parameters, such as body weight and fat-free mass, showed a tendency toward improvement, but the differences were not significant. The subjective parameters, in particular the Kondrup score (P = .0165) and the subjective global assessment score (P = .0065) after follow-up improved significantly in the experimental group, compared with the control group. Both enteral regimens were safe and well tolerated.
  
  
  CONCLUSIONS
  Enteral nutrition with EPA and DHA may be advantageous in patients with head and neck or esophageal cancer by improving parameters of nutritional and functional status during CRT.
authors.affiliation: Department of Radiation Oncology, Erlangen University Hospital, Erlangen, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Fietkau
authors.forename: Victor
authors.initials: V
authors.lastname: Lewitzki
authors.forename: Thomas
authors.initials: T
authors.lastname: Kuhnt
authors.forename: Tobias
authors.initials: T
authors.lastname: Hölscher
authors.forename: Clemens-F
authors.initials: CF
authors.lastname: Hess
authors.forename: Bernhard
authors.initials: B
authors.lastname: Berger
authors.forename: Thomas
authors.initials: T
authors.lastname: Wiegel
authors.forename: Claus
authors.initials: C
authors.lastname: Rödel
authors.forename: Marcus
authors.initials: M
authors.lastname: Niewald
authors.forename: Robert M
authors.initials: RM
authors.lastname: Hermann
authors.forename: Dorota
authors.initials: D
authors.lastname: Lubgan
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D004281:Docosahexaenoic Acids / Q000008:administration & dosage; D004311:Double-Blind Method; D015118:Eicosapentaenoic Acid / Q000008:administration & dosage; D004750:Enteral Nutrition / Q000379:methods*; D004938:Esophageal Neoplasms / Q000178:diet therapy* / Q000188:drug therapy / Q000532:radiotherapy; D005260:Female; D005526:Food, Formulated; D006258:Head and Neck Neoplasms / Q000178:diet therapy* / Q000188:drug therapy / Q000532:radiotherapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D004281:Docosahexaenoic Acids; D015118:Eicosapentaenoic Acid
keywords: concurrent chemoradiotherapy; docosahexaenoic acid; eicosapentaenoic acid; esophageal cancer; head and neck cancer; nutritional status; nutritional therapy; supportive care