| ObjectiveTo investigate the effect of glutamine, EPA and branched-chain amino acids supplements in the esophageal cancer patients on concurrent chemo-radiotherapy and gastric cancer patients on chemotherapy.MethodsThis is a prospective, randomized, controlled clinical study. From April 2013 to April 2014, a total of 104 esophageal and gastric carcinoma patients with chemotherapy or concurrent chemo-radiotherapy were recruited and randomly divided into experimental group and control group by random digits table. These patients all complied with the inclusion and exclusion criteria and volunteered for the study. The two groups were all under treatment of nutritional support team, and received dietary counseling and routine nutritional support, while only the experimental group received glutamine (20 g/d), EPA (3.3 g/d) and branched-chain amino acids (8 g/d) supplements. We compared the body composition analysis, blood indicators, incidence of complications, completion rates of therapy and the quality of life between the two groups. The quality of life was assessed using Chinese versions of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ)-C30 and EORTC QLQ-OES18.The use of these questionnaires in this study protocol was permitted by Quality of Life Unit,EORTC Data Center.All patients completes these questionnaires before treatment and after therapy.All the scoring procedures were made according to the suggestions presented in EORTC QLQ-C30 Scoring manual. Symptom and functional scores were linearly transformed so that results ranged from 0 to 100. The data was analyzed with the software package SPSS 20.0 for Windows. Statistical analysis of the data was performed by using procedure of Independent-Samples t-test. A high score fora functional scale represents a high/healthy level of functioning,a high score for the global health status/QOL represents a high QL, but a high score for a symptom scale/item represents a high level of symptomatology/problems. A p value less than 0.05 was considered significant.ResultsAfter treatment, body weight assessed by BIA remained stable in experimental group (0.46±2.19, p>0.05), while decreased in the control group (-2.52±2.57, p <0.05). Free fat mass and muscle weight assessed by BIA enhanced significantly in experiment group, while decreased in the control group (p<0.05). Besides, albumin, red blood cell count, white blood cell count and blood platelet count remained stable in the experiment group while declined significantly in the control group. During the treatment, compared to the control group, the incidences of infection associated complication were fower (6% vs 19%,p<0.05) and the completion rates of therapy were significantly higher (96% vs 83%, p<0.05) in the experiment group. Baseline functional and symptom QL MEAN scores were similar in both groups. All patients reported worse functional, symptom and global QL scores(QOL) after therapy than before. Significant differences between the two groups were found in global health(QOL),pain and reflux scales.ConclusionThe results showed that glutamine, EPA and branched-chain amino acids supplements can help maintain nutrition status, decrease the complications, and improve compliance for esophageal cancer patients with concurrent chemo-radiotherapy and gastric cancer patients with post-operative adjuvant chemotherapy. Comparing with the control group, the experimental group can improve the quality of life. |
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