title: Immunonutrition improves functional capacities in head and neck and esophageal cancer patients undergoing radiochemotherapy: a randomized clinical trial.
abstract: OBJECTIVE
  Malnutrition is frequent in head and neck (HN) and esophageal cancer patients and aggravated by radiochemotherapy (RCT), increasing morbi-mortality and treatment toxicity. Our goal was to investigate the effect of immunonutrition consisting of an arginine, omega-3 fatty acid, nucleotides-enriched diet on nutritional status, and functional capacity in HN or esophageal cancer patients undergoing RCT.
  
  
  METHODS
  37 patients were randomized in a double-blind clinical trial. 5 days before and until the end of RCT (5-7 weeks), they received either an Immunomodulating Enteral Nutrition (IEN) or an isonitrogenous, isoenergetic Standard Enteral Nutrition (SEN). Anthropometrical parameters, nutritional risk index (NRI), serum albumin, plasma antioxidant capacity, and functional capacity were recorded between the beginning and the end of RCT.
  
  
  RESULTS
  A significant gain in total body weight (+2.1 ± 3.1 kg) was observed in IEN patients. Albuminemia and NRI were improved concomitantly in IEN malnourished patients. Plasma antioxidant capacity was improved (+100 ± 13 μM EqTrolox) in IEN patients. Functional capacity measured by WHO Performance Status and Karnofsky index was maintained in IEN patients but significantly reduced in SEN patients.
  
  
  CONCLUSIONS
  These preliminary data show that immunonutrition could improve the nutritional status together with functional capacity in HN and esophageal cancer patients undergoing RCT.
  
  
  BACKGROUND
  This clinical trial promoted by the University Hospital Center of Clermont-Ferrand has been registered at ClinicalTrial.gov website under the following reference: NCT00333099.
authors.affiliation: CHU Clermont-Ferrand, Centre Jean Perrin, Unité de Nutrition, CLARA, F-63000 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, UMR 1019, Unité de Nutrition Humaine, CRNH-Auvergne, BP 10448, F-63000 Clermont-Ferrand, France. Electronic address: M-paule.vasson@udamail.fr.
authors.forename: M-P
authors.initials: MP
authors.lastname: Vasson
authors.affiliation: Clermont Université, Université d'Auvergne, UMR 1019, Unité de Nutrition Humaine, CRNH-Auvergne, BP 10448, F-63000 Clermont-Ferrand, France.
authors.forename: J
authors.initials: J
authors.lastname: Talvas
authors.affiliation: Clermont Université, Université d'Auvergne, UMR 1019, Unité de Nutrition Humaine, CRNH-Auvergne, BP 10448, F-63000 Clermont-Ferrand, France.
authors.forename: O
authors.initials: O
authors.lastname: Perche
authors.affiliation: Centre Jean Perrin, Service d'Oncologie Médicale, F-63000 Clermont-Ferrand, France.
authors.forename: A-F
authors.initials: AF
authors.lastname: Dillies
authors.affiliation: Centre Léon Bérard, Unité de Nutrition Clinique, F-69000 Lyon, France.
authors.forename: P
authors.initials: P
authors.lastname: Bachmann
authors.affiliation: CHU Clermont-Ferrand, Service de Chirurgie Digestive, F-63003 Clermont-Ferrand, France.
authors.forename: D
authors.initials: D
authors.lastname: Pezet
authors.affiliation: CHU Clermont-Ferrand, Service de Médecine Digestive et Hépatobiliaire, F-63003 Clermont-Ferrand, France.
authors.forename: A-C
authors.initials: AC
authors.lastname: Achim
authors.affiliation: Centre Léon Bérard, Service de Radiothérapie, F-69000 Lyon, France.
authors.forename: P
authors.initials: P
authors.lastname: Pommier
authors.affiliation: Centre Léon Bérard, Unité de Nutrition Clinique, F-69000 Lyon, France.
authors.forename: S
authors.initials: S
authors.lastname: Racadot
authors.affiliation: CH Béziers, Service de Gastro-Entérologie, F-34500 Béziers, France.
authors.forename: A
authors.initials: A
authors.lastname: Weber
authors.affiliation: CH Béziers, Service de Gastro-Entérologie, F-34500 Béziers, France.
authors.forename: M
authors.initials: M
authors.lastname: Ramdani
authors.affiliation: Centre Jean Perrin, Service de Statistiques, F-63000 Clermont-Ferrand, France.
authors.forename: F
authors.initials: F
authors.lastname: Kwiatkowski
authors.affiliation: Clermont Université, Université d'Auvergne, UMR 1019, Unité de Nutrition Humaine, CRNH-Auvergne, BP 10448, F-63000 Clermont-Ferrand, France; CHU Clermont-Ferrand, Service de Médecine Digestive et Hépatobiliaire, F-63003 Clermont-Ferrand, France.
authors.forename: C
authors.initials: C
authors.lastname: Bouteloup
mesh_terms: D000368:Aged; D000886:Anthropometry; D001120:Arginine / Q000008:administration & dosage / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D059248:Chemoradiotherapy / Q000379:methods; D004311:Double-Blind Method; D004750:Enteral Nutrition / Q000379:methods*; D004938:Esophageal Neoplasms / Q000178:diet therapy* / Q000532:radiotherapy; D005229:Fatty Acids, Monounsaturated / Q000008:administration & dosage / Q000097:blood; D005231:Fatty Acids, Unsaturated / Q000008:administration & dosage / Q000097:blood; D005260:Female; D005526:Food, Formulated / Q000032:analysis; D006258:Head and Neck Neoplasms / Q000178:diet therapy* / Q000532:radiotherapy; D006801:Humans; D056747:Immunomodulation / Q000502:physiology; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D012709:Serum Albumin; D016896:Treatment Outcome
chemical_list: D005229:Fatty Acids, Monounsaturated; D005231:Fatty Acids, Unsaturated; D012709:Serum Albumin; D002097:C-Reactive Protein; D001120:Arginine
keywords: Esophageal cancer; Head and neck cancer; Immunonutrition; Radiochemotherapy