Echium oil is not protective against weight loss in head and neck cancer patients undergoing curative radio(chemo)therapy: a randomised-controlled trial

Lies Pottel, Michelle Lycke, Tom Boterberg, Hans Pottel, Laurence Goethals, Fréderic Duprez, Alex Maes, Stefan Goemaere, Sylvie Rottey, Imogen Foubert, Philip R Debruyne, Lies Pottel, Michelle Lycke, Tom Boterberg, Hans Pottel, Laurence Goethals, Fréderic Duprez, Alex Maes, Stefan Goemaere, Sylvie Rottey, Imogen Foubert, Philip R Debruyne

Abstract

Background: Therapy-induced mucositis and dysphagia puts head and neck (H&N) cancer patients at increased risk for developing cachexia. Omega-3 fatty acids (n-3 FA) have been suggested to protect against cachexia. We aimed to examine if echium oil, a plant source of n-3 FA, could reduce weight loss in H&N cancer patients undergoing radio(chemo)therapy with curative intent.

Methods: In a double-blind trial, patients were randomly assigned to echium oil (intervention (I) group; 7.5 ml bis in die (b.i.d.), 235 mg/ml α-linolenic acid (ALA) + 95 mg/ml stearidonic acid (SDA) + 79 mg/ml γ-linolenic acid (GLA)) or n-3 FA deficient sunflower oil high oleic (control (C) group; 7.5 ml b.i.d.) additional to standard nutritional support during treatment. Differences in percentage weight loss between both groups were analysed according to the intention-to-treat principle. Erythrocyte FA profile, body composition, nutritional status and quality of life were collected.

Results: Ninety-one eligible patients were randomised, of whom 83 were evaluable. Dietary supplement adherence was comparable in both groups (median, I: 87%, C: 81%). At week 4, the I group showed significantly increased values of erythrocyte n-3 eicosapentanoic acid (EPA, 14% vs -5%) and n-6 GLA (42% vs -20%) compared to the C group, without a significant change in n-6 arachidonic acid (AA, 2% vs -1%). Intention-to-treat analysis could not reveal a significant reduction in weight loss related to echium oil consumption (median weight loss, I: 8.9%, C: 7.6%). Also, no significant improvement was observed in the other evaluated anthropometric parameters.

Conclusions: Echium oil effectively increased erythrocyte EPA and GLA FAs in H&N cancer patients. It failed however to protect against weight loss, or improve nutritional parameters.

Trial registration: ClinicalTrials.gov Identifier NCT01596933.

Figures

Figure 1
Figure 1
Patient allocation flow diagram.
Figure 2
Figure 2
Percent change in erythrocyte fatty acid profile after dietary supplement consumption. The I and C group values are presented as respectively red squares and blue diamonds, and the resp. full and dashed line. A. Percent change in EPA in I (r 0.50, P < 0.01) and C (r −0.17, P > 0.05), B. Percent change in DGLA in I (r 0.60, P < 0.0001) and C (r −0.24, P > 0.05), C. Percent change in ALA in I (r 0.43, P < 0.01) and C (r −0.19, P > 0.05), and D. Percent change in AA in I (r 0.16, P > 0.05) and C (r −0.28, P > 0.05). EPA: eicosapentaenoic acid, ALA: α-linolenic acid, DGLA: dihomo-γ-linolenic acid, AA: arachidonic acid.

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