title: Randomized study of antiinflammatory and immune-modulatory effects of enteral immunonutrition during concurrent chemoradiotherapy for esophageal cancer.
abstract: Concurrent chemoradiotherapy (CCRT) induces toxicities from inflammation and immunological suppression. Omega-3 fatty acids, glutamine, and arginine are therapeutic factors that can attenuate such inflammation and promote cellular immunity. The question is whether immunonutrition (IN) during CCRT reduces inflammation and improves the immune function in patients with esophageal squamous cell carcinoma (ESCC). Seventy-one locally advanced ESCC patients being treated with CCRT (5-FU and cisplatin) were randomized into 2 groups. The IN group received a combination of omega-3 fatty acids, glutamine, and arginine, whereas the control group received standard formula. The levels of C-reactive protein (CRP), tumor necrosis factor (TNF), interferon-gamma (IFN), interleukin (IL-6, IL-10), CD3, CD4, CD8, white blood cells, neutrophils, and total lymphocytes were measured before and during treatment. The levels of CRP (P = 0.001) and TNF (P = 0.014) increased more during treatment in the control group than the treatment group, whereas IFN, IL-6, and IL-10 were similar but not significantly. CD3, CD4, CD8, white blood cells, neutrophils, and total lymphocytes decreased more in the control group than in the treatment group, but not significantly. Enteral IN during CCRT reduced the increase of inflammatory cytokine levels.
authors.affiliation: a Department of Surgery, Faculty of Medicine , Prince of Songkla University , Songkla , Thailand.
authors.forename: Somkiat
authors.initials: S
authors.lastname: Sunpaweravong
authors.forename: Puttisak
authors.initials: P
authors.lastname: Puttawibul
authors.forename: Sakchai
authors.initials: S
authors.lastname: Ruangsin
authors.forename: Supparerk
authors.initials: S
authors.lastname: Laohawiriyakamol
authors.forename: Patrapim
authors.initials: P
authors.lastname: Sunpaweravong
authors.forename: Duangjai
authors.initials: D
authors.lastname: Sangthawan
authors.forename: Jintana
authors.initials: J
authors.lastname: Pradutkanchana
authors.forename: Ponpis
authors.initials: P
authors.lastname: Raungkhajorn
authors.forename: Alan
authors.initials: A
authors.lastname: Geater
mesh_terms: D000328:Adult; D000368:Aged; D001120:Arginine / Q000008:administration & dosage; D002097:C-Reactive Protein / Q000378:metabolism; D002294:Carcinoma, Squamous Cell / Q000628:therapy*; D059248:Chemoradiotherapy / Q000009:adverse effects / Q000379:methods*; D002945:Cisplatin / Q000627:therapeutic use; D004750:Enteral Nutrition; D004938:Esophageal Neoplasms / Q000628:therapy*; D000077277:Esophageal Squamous Cell Carcinoma; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D005973:Glutamine / Q000008:administration & dosage; D006801:Humans; D007111:Immunity, Cellular / Q000187:drug effects; D018836:Inflammation Mediators / Q000097:blood*; D007371:Interferon-gamma / Q000097:blood; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D055815:Young Adult
chemical_list: D015525:Fatty Acids, Omega-3; D018836:Inflammation Mediators; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D005973:Glutamine; D016753:Interleukin-10; D007371:Interferon-gamma; D002097:C-Reactive Protein; D001120:Arginine; D002945:Cisplatin; D005472:Fluorouracil