Abstract
BackgroundLike many other cancer patients, most pancreatic carcinoma patients suffer from severe weight loss. As shown in numerous studies with fish oil (FO) supplementation, a minimum daily intake of 1.5 g n-3-fatty acids (n-3-FA) contributes to weight stabilization and improvement of quality of life (QoL) of cancer patients. Given n-3-FA not as triglycerides (FO), but mainly bound to marine phospholipids (MPL), weight stabilization and improvement of QoL has already been seen at much lower doses of n-3-FA (0,3 g), and MPL were much better tolerated. The objective of this double-blind randomized controlled trial was to compare low dose MPL and FO formulations, which had the same n-3-FA amount and composition, on weight and appetite stabilization, global health enhancement (QoL), and plasma FA-profiles in patients suffering from pancreatic cancer.MethodsSixty pancreatic cancer patients were included into the study and randomized to take either FO- or MPL supplementation. Patients were treated with 0.3 g of n-3-fatty acids per day over six weeks. Since the n-3-FA content of FO is usually higher than that of MPL, FO was diluted with 40% of medium chain triglycerides (MCT) to achieve the same capsule size in both intervention groups and therefore assure blinding. Routine blood parameters, lipid profiles, body weight, and appetite were measured before and after intervention. Patient compliance was assessed through a patient diary. Quality of life and nutritional habits were assessed with validated questionnaires (EORTC-QLQ-C30, PAN26). Thirty one patients finalized the study protocol and were analyzed (per-protocol-analysis).ResultsIntervention with low dose n-3-FAs, either as FO or MPL supplementation, resulted in similar and promising weight and appetite stabilization in pancreatic cancer patients. MPL capsules were slightly better tolerated and showed fewer side effects, when compared to FO supplementation.ConclusionThe similar effects between both interventions were unexpected but reliable, since the MPL and FO formulations caused identical increases of n-3-FAs in plasma lipids of included patients after supplementation. The effects of FO with very low n-3-FA content might be explained by the addition of MCT. The results of this study suggest the need for further investigations of marine phospholipids for the improvement of QoL of cancer patients, optionally in combination with MCT.
Highlights
Like many other cancer patients, most pancreatic carcinoma patients suffer from severe weight loss
The results of this study suggest the need for further investigations of marine phospholipids for the improvement of quality of life (QoL) of cancer patients, optionally in combination with medium chain triglycerides (MCT)
Since the study of Taylor was performed with patients suffering from different cancer types and was a noncontrolled interventional trial, the aim of the present study was to compare the effect of an identical composition and low amount of n-3-fatty acids (n-3-Fatty acid (FA)) (300 mg/day) either given as marine phospholipids (MPL)- and as fish oil (FO)-formulation on body weight, appetite global health (QoL) and on the FA-profiles in plasma in pancreatic cancer patients
Summary
Like many other cancer patients, most pancreatic carcinoma patients suffer from severe weight loss. Given n-3FA not as triglycerides (FO), but mainly bound to marine phospholipids (MPL), weight stabilization and improvement of QoL has already been seen at much lower doses of n-3-FA (0,3 g), and MPL were much better tolerated The objective of this double-blind randomized controlled trial was to compare low dose MPL and FO formulations, which had the same n-3-FA amount and composition, on weight and appetite stabilization, global health enhancement (QoL), and plasma FA-profiles in patients suffering from pancreatic cancer. 80% of all patients with advanced pancreatic cancer die because of cancer cachexia [1] This condition is usually accompanied with appetite loss and lower quality of life (QoL) [2]. The activity of proinflammatory mediators like the cytokines TNFα, IL-1 and IL-6 as well as INF-γ lead to catabolic processes like lipolysis, proteolysis, and increased resting energy expenditure [2, 4,5,6] The cytokine release stimulates the production of pro-inflammatory eicosanoids like PGE2, PGF2a, PGD2, PGI2 and TXA2 – all bioactive lipid-second-messengers [7, 8] derived from arachidonic acid (AA), which is a n-6-polyunsaturated fatty acid (20:4 (n − 6))
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