Enteral Nutrition During Multimodality Therapy in Upper Gastrointestinal Cancer Patients

Abstract

The objective of this study was to evaluate long-term enteral nutrition support in postoperative cancer patients. Multimodality therapy of surgical patients with upper gastrointestinal malignancies may improve survival, but often results in substantial malnutrition, immunosuppression, and morbidity. The benefits of combined inpatient and outpatient enteral feeding with standard diets or diets supplemented with arginine, RNA + ω-3 fatty acids are unclear. Sixty adult patients with esophageal (22), gastric (16), and pancreatic (22) lesions were stratified by disease site and percent usual weight and randomized to receive supplemental or standard diet via jejunostomy beginning on the first postoperative day (goal = 25 kcal/kg/day) until hospital discharge. Patients also were randomized to receive (n = 37) or not receive (n = 23) enteral jejunostomy feedings (1000 kcal/day overnight) for the 12− to 16-week recovery and radiation/chemotherapy periods. Plasma and peripheral white blood cells were obtained for fatty acid levels and PGE2 production measurements. Mean plasma and cellular ω3/ω6 fatty acid levels (percent composition) increased significantly (p Conclusions Supplemental enteral feeding significantly increased plasma and peripheral white blood cell ω3/ω6 ratios and significantly decreased PGE2 production and postoperative infectious/wound