The Effect of Nutrition Intervention with Oral Nutritional Supplements on Pancreatic and Bile Duct Cancer Patients Undergoing Chemotherapy.

Seong Hyeon Kim, Song Mi Lee, Hei Cheul Jeung, Ik Jae Lee, Joon Seong Park, Mina Song, Dong Ki Lee, Seung-Min Lee

Journal: Nutrients 2019;11(5):1145

PMID: 31121926

Plain Language Summary

Despite the advantages of chemotherapy, it can cause cancer-related malnutrition leading to both reduced quality of life and reduced survival rate. Oral nutritional supplements (ONSs) provide balanced nutrients, calories, and protein to complement insufficient oral intake, and ONS provision during treatment may improve nutritional status. The aim of this study was to investigate the impact of ONS on nutritional status in patients undergoing chemotherapy for pancreatic and bile duct cancer. Patients were randomly allocated to the ONS group (15) and non-ONS group (19) and dietary intake and body weight were assessed at weeks 1, 2, 4 and 8. Body composition and quality of life was assessed at baseline and week 8. This study found the supply of ONS helped promote health by increasing body fat mass, improving quality of life and decreasing fatigue symptoms in pancreatic and bile duct cancer patients. These results were more pronounced in patients in the first cycle of chemotherapy. Based on these results, the authors conclude ONS may improve nutritional status by increasing fat mass and/or maintaining the body composition of patients undergoing chemotherapy.

Abstract

Chemotherapy may negatively affect nutritional status and quality of life (QOL) in pancreatic cancer patients. Our aim was to investigate the beneficial effects of oral nutrition supplements (ONS) on pancreatic and bile duct cancer patients undergoing chemotherapy. Among patients with progressive pancreatic and bile duct cancer receiving chemotherapy, the ONS group ( = 15) received two packs of ONS daily for 8 weeks while the non-ONS group ( = 19) did not. Anthropometric measures, dietary intake, nutritional status, and quality of life were assessed. ONS significantly increased daily intakes of energy, carbohydrates, proteins, and lipids at 8 weeks compared to the baseline. After 8 weeks, fat mass significantly increased in the ONS group. For patients in their first cycle of chemotherapy, body weight, fat-free mass, skeletal muscle mass, body cell mass, and fat mass increased in the ONS group but decreased in the non-ONS group. Fat mass increased in second or higher cycle only in the ONS group. Patient-generated subjective global assessments (PG-SGA) and fatigue scores in the Quality of Life Questionnaire Core 30 (QLQ-C30) improved in the ONS group. ONS might improve nutritional status by increasing fat mass and/or maintaining the body composition of pancreatic and bile duct cancer patients with chemotherapy, especially those in the first cycle, and alleviate fatigue symptoms.

Address: Clinical Nutrition Program, Graduate School of Human Environmental Sciences, Yonsei University, Seoul 03722, Korea. [email protected].; Department of Nutrition Care, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea. [email protected].; Cancer Metastasis Research Center, Division of Medical Oncology, Cancer Center Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea. [email protected].; Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea. [email protected].; Pancreatobiliary Cancer Clinic, Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea. [email protected].; Department of Food and Nutrition, Brain Korea 21 PLUS Project, College of Human Ecology, Yonsei University, Seoul 03722, Korea. [email protected].; Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea. [email protected].; Department of Food and Nutrition, Brain Korea 21 PLUS Project, College of Human Ecology, Yonsei University, Seoul 03722, Korea. [email protected].

DOI: 10.3390/nu11051145

Patient Centred Factor

Mediators: Oral nutritional supplement

Clinical Imbalances

Detoxification and Biotransformation Immune and inflammation Gastro-intestinal

Laboratory Testing

Blood

Modifiable Lifestyle Factors

Diet

Nutrition Evidence Keywords

Fatigue Cancer Malnutrition Chemotherapy Adipose tissue Quality of life Body fat mass Cachexia Dietetics Oral nutrition supplement

Bioactive Substances

Chemotherapy

Link outs

Free resources

Full Text Sources:

Medical:

https://medlineplus.gov/dietarysupplements.html

MeSH Terms: Aged, Bile Duct Neoplasms, Body Composition, Body Weight, Diet, Dietary Supplements, Energy Intake, Female, Humans, Male, Nutrition Therapy, Nutritional Status, Pancreatic Neoplasms, Prospective Studies, Quality of Life, Surveys and Questionnaires