Role of omega-3 fatty acids in parenteral nutrition of cancer patients

Abstract

Relevance. When selecting the components of parenteral nutrition (PN) for oncology patients, it is necessary to take into account not only the composition optimization but also its potential positive effect on the surgical treatment outcome. Therefore, the use of pharmaconutrients in PN, in particular, omega-3 fatty acids, is of great theoretical and practical interest and has determined the aim of this study.The aim. To assess the effiacy of postoperative PN using the 3-in-1 system with omega-3 fatty acids (FA) (SMOFKabiven central and peripheral) in the treatment of metabolic disorders in patients undergoing gastrointestinal cancer surgery.Materials and methods. A prospective, randomized, controlled, comparative study included the patients undergoing gastrointestinal cancer surgery. Group 1 (comparison group) consisted of 29 patients, postoperative PN was performed using a 3-in-1 system without omega-3 fatty acids.Group 2 (main group) consisted of 20 patients treated with 3-in-1 system with omega-3 FA (SMOFKabiven central) and 9 patients recieved PN with omega-3 FA through peripheral vein access FA (SMOFKabiven peripheral).Main results. A complete range of amino acids in SMOFKabiven (50 g/L) and an increased content of nitrogen (8 g/L) have a pronounced effect on protein metabolism and anabolic processes. The long-term PN showed that the liver enzyme (alanine transaminase [ALT], aspartate transaminase [AST], and total bilirubin) levels were signifiantly lower compared to the patients who received traditional lipid emulsions without fih oil. The analysis of the corrective effect of PN containing omega-3 fatty acids showed that at day 6–7 after surgery the group 2 patients had a signifiant decrease in the concentration of pro-inflmmatory cytokines: IL-6 down to 79.5±19.2 pg/mL, TNF-α down to 12.9±3.3 pg/mL (p < 0.05) compared to group 1. Clinical signs of gastrointestinal dysfunction were mainly resolved at day 4–5. Full recovery of the GIT functions was seen in more than 80 % of patients. The anti-inflmmatory properties of omega-3 fatty acids, as well as their effect on the cytokine balance recovery, have been confimed in our studies by signifiant reductions in the synthesis of IL-6, TNF.Conclusion. The high content of omega-3 fatty acids in PN promotes early management of metabolic disorders after surgery, can have a signifiant effect on the ability to adequately tolerate the maintenance chemotherapy and radiation therapy, and can signifiantly improve the quality of life under the conditions of progressive disease.