Effects of Enteral Nutrition on Patients With Oesophageal Carcinoma Treated With Concurrent Chemoradiotherapy: A Prospective, Multicentre, Randomised, Controlled Study

Jiahua Lyu, Anhui Shi, Tao Li, Jie Li, Ren Zhao, Shuchai Zhu, Jianhua Wang, Ligang Xing, Daoke Yang, Conghua Xie, Liangfang Shen, Hailin Zhang, Guangying Zhu, Jing Wang, Wenyan Pan, Fang Li, Jinyi Lang, Hanping Shi, Jiahua Lyu, Anhui Shi, Tao Li, Jie Li, Ren Zhao, Shuchai Zhu, Jianhua Wang, Ligang Xing, Daoke Yang, Conghua Xie, Liangfang Shen, Hailin Zhang, Guangying Zhu, Jing Wang, Wenyan Pan, Fang Li, Jinyi Lang, Hanping Shi

Abstract

Background: The oesophageal carcinoma patients show high incidence of malnutrition, which negatively affects their therapy outcome. Moreover, benefits of enteral nutrition remain to be studied in details in these patients. Therefore, we set to assess the effects of enteral nutrition on the nutritional status, treatment toxicities and survival in the oesophageal carcinoma patients treated with concurrent chemoradiotherapy (CCRT).

Materials and methods: Eligible patients were randomly assigned to either the experimental or control group. The patients in the experimental group were treated with a whole-course enteral nutrition management, while the control group were provided a unsystematic nutrition without setting intake goals for energy and protein. The primary endpoint was a change in body weight, while the secondary endpoints included nutrition-related haematological indicators, toxicities, completion rate of treatment and survival.

Results: A total of 222 patients were randomised to either the experimental (n=148) or control (n=74) group. Patients in the experimental group showed significantly less decrease in body weight, serum albumin and haemoglobin levels, a lower incidence rates of grade ≥3 myelosuppression and infection, and a higher completion rate of CCRT than those in the control group. While analyses of the 2 and 3 year overall survival (OS) and progression-free survival (PFS) did not reveal differences between these groups, we observed a significantly higher OS at 1 year (83.6% vs. 70.0%). In the subgroup analysis, patients with patient-generated subjective global assessment (PG-SGA)=C were likely to have better OS and PFS with enteral nutrition.

Conclusions: In EC patients treated with CCRT, enteral nutrition conferred positive effects on the nutritional status, treatment toxicities and prognosis, which mandate its inclusion in clinical practice.

Clinical trial registration: This prospective trial has been registered with www.clinicaltrials.gov as NCT02399306.

Keywords: chemoradiotherapy; enteral nutrition; nutritional status; oesophageal carcinoma; prognosis.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2022 Lyu, Shi, Li, Li, Zhao, Zhu, Wang, Xing, Yang, Xie, Shen, Zhang, Zhu, Wang, Pan, Li, Lang and Shi.

Figures

Figure 1
Figure 1
Kaplan-Meier overall survival curves for patients in the experimental group vs. control group.
Figure 2
Figure 2
Overall survival curves for patients with tumour length ≥ 5cm in the experimental group vs. control group.
Figure 3
Figure 3
Overall survival curves for patients with PG-SGA qualitative evaluation = C in the experimental group vs. control group.
Figure 4
Figure 4
Progression-free survival curves for patients in the experimental group vs. control group.
Figure 5
Figure 5
Progression-free survival curves for patients with PG-SGA qualitative evaluation = C in the experimental group vs. control group.

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Source: PubMed

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