Does omega-3 PUFA-enriched oral nutritional intervention benefit cancer patients receiving chemo (radio) therapy? A systematic review and meta-analysis of randomized controlled trials

Abstract

Although data indicate omega-3 polyunsaturated fatty acids are beneficial nutrients in cancer therapy, the evidences for efficacy of nutritional interventions during chemo (radio) therapy are still limited. The leading goal of the present meta-analysis was to summarize randomized controlled trials involving the administration of ω-3 PUFA-enriched oral nutritional supplements during chemo (radio) therapy, and evaluate the effects on nutritional status and clinical outcomes in patients. We systematically searched PubMed, Embase, Web of Science, Cochrane databases to identify interventions assessing body weight, BMI, immune and inflammatory indicators, plasma omega-3 fatty acids and adverse events, with subgroup analyses for region, types of ω-3 fatty acids, dose, duration and dosage form. In total, 22 studies including 1155 participants met the inclusion criteria. Meta-analysis showed a significant increase in body weight (BW) (WMD = 0.59 kg, 95% CI: 0.06, 1.13, P = 0.03), body mass index (BMI) (WMD = 0.43 kg/m², 95% CI: 0.07, 0.79, P = 0.02), and plasma total ω-3 fatty acids (SMD = 2.52, 95% CI: 1.27, 3.78, P<0.0001), and a significant reduction in plasma levels of C-reactive protein (CRP) (SMD= −0.53, 95% CI: −0.80, −0.25, P = 0.0001), tumor necrosis factor-α (TNF-α) (WMD = −0.40 pg/mL, 95% CI: −0.80, −0.01, P = 0.05), interleukin 6 (IL-6) (WMD = −1.25 pg/mL, 95% CI: −2.41, −0.10, P = 0.03) and the incidence of adverse events (RR= 0.72, 95% CI: 0.54, 0.95, P = 0.02). However, plasma albumin levels (WMD = 0.02 mg/dL, 95% CI: −0.13, 0.18, P = 0.75) was remained unaffected. Overall, our meta-analysis provides evidences that the consumption of ω-3 PUFA-enriched oral nutritional supplements exert beneficial effects on nutritional status and clinical outcomes in patients undergoing chemo (radio) therapy.

Keywords:

• cancer patient
• chemo (radio) therapy
• meta-analysis
• omega-3 PUFAs
• oral nutrition supplement
• randomized controlled trials

Disclosure statement

No potential conflict of interest was reported by the authors.

Author contributions

X.W. and Q.J. contributed in conception and design of the manuscript. Y.W., M.C., R.L., W.W., and Y.G. contributed in literature search, data extraction, quality assessment, statistical analysis and manuscript drafting. All authors read and approved the final manuscript.

Additional information

Funding

This work was supported by the National First-Class Discipline Program of Food Science and Technology (JUFSTR20180202), the National Natural Science Foundation of China (Grant No. 31972037), and the Overseas Expertise Introduction Project for Discipline Innovation (111 Project, B90719028).