• Hiroshi Miyata, Masahiko Yano, Takushi Yasuda, Makoto Yamasaki, Kohei Murakami, Tomoki Makino, Kohei Nishiki, Keijiro Sugimura, Masaaki Motoori, Osamu Shiraishi, Masaki Mori, and Yuichiro Doki.
• Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan; Department of Digestive Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan. Electronic address: Hmiyata@gesurg.med.osaka-u.ac.jp.
• Nutrition. 2017 Jan 1; 33: 204-210.

ObjectivesOmega-3 (ω-3) fatty acids have potential positive effects during chemotherapy, such as body weight maintenance and muscle mass preservation. However, little is known about the effect this supplement might have on reducing chemotherapy-induced toxicities. The aim of this study was to determine the usefulness of ω-3 fatty acid supplementation in the reduction of chemotherapy-related toxicities.MethodsSixty-one patients undergoing neoadjuvant chemotherapy for esophageal cancer randomly received ω-3-rich enteral nutrition (EN; n = 31) or ω-3-poor EN support (n = 30) for 15 d during chemotherapy. The daily dosage of ω-3 fatty acids was 900 mg in the ω-3-rich group and 250 mg in the ω-3-poor group. The primary endpoint was the frequency of grade 3/4 neutropenia, and secondary endpoints included other chemotherapy-related adverse events, body weight, and inflammatory markers.ResultsThe total and dietary intake calories during chemotherapy were equal in both groups. There was no significant difference in the body weight change after chemotherapy between the two groups. There was no significant difference in the incidence of grade 3/4 leukopenia and neutropenia (P > 0.05). However, stomatitis was significantly less frequent in the ω-3-rich group, than in the ω-3-poor group (P = 0.018). Grade 3/4 diarrhea occurred relatively less frequently in the ω-3-rich group than in the ω-3-poor group; however, this difference was not significant (16.1% versus 36.7%, respectively, P = 0.068). Increases in the aspartate aminotransferase and alanine aminotransferase levels were seen significantly less frequently in the ω-3-rich group than in the ω-3-poor group (P = 0.012 and P = 0.015, respectively).Conclusionsω-3-rich EN support decreased the frequency of chemotherapy-induced mucosal toxicities, such as stomatitis and diarrhea, and exhibited a hepatoprotective effect during chemotherapy, compared with the ω-3-poor EN support.Copyright © 2016 Elsevier Inc. All rights reserved.

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