肺癌に対するプロシュア対エンシュア

肺がん患者に対するプロシュア対エンシュアのRCT論文を紹介します。

van der Meij BS, Langius JA, Spreeuwenberg MD, Slootmaker SM, Paul MA, Smit EF, van Leeuwen PA. Oral nutritional supplements containing n-3 polyunsaturated fatty acids affect quality of life and functional status in lung cancer patients during multimodality treatment: an RCT. Eur J Clin Nutr. 2012 Mar;66(3):399-404. doi: 10.1038/ejcn.2011.214.

下記のHPで論文を全文見ることができます。

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3303137/?tool=pubmed

リサーチクエスチョンは以下の通りです。

P：肺がん患者（StageⅢ、除く小細胞がん）が
I：プロシュアを1日2本飲むと
C：エンシュアを1日2本飲む場合と比較して
O：QOLと機能が改善する
D：ランダム化比較試験

プロシュアは下記HPを参照してください。EPA、DHAを多く含む栄養剤です。
http://www.abbott.co.jp/general/nourishment/prosure_main.asp

結果ですが、服用開始3週間後、5週間後のQOLと機能（PS）は介入群で有意に改善していましたが、握力は両群で有意差を認めませんでした。身体活動は介入群で高い傾向にありました。以上より、EPA、DHAは肺がん患者のQOL、機能維持・改善に有用な可能性があります。

なおCOIとして一部の著者はアボットからの資金提供を受けていますので、この点で解釈に注意が必要です。また、プロシュアを1日2本継続して飲むことは、嗜好の問題で個人的には無理です(笑)。エンシュア2本＋エパデール1日2gなら頑張れるかもしれませんが…。

Abstract

BACKGROUND/OBJECTIVES:

Our objective was to investigate effects of an oral nutritional supplement containing n-3 polyunsaturated fatty acids (FAs) on quality of life, performance status, handgrip strength and physical activity in patients with non-small cell lung cancer (NSCLC) undergoing multimodality treatment.

SUBJECTS/METHODS:

In a double-blind experiment, 40 patients with stage III NSCLC were randomised to receive 2 cans/day of a protein- and energy-dense oral nutritional supplement containing n-3 polyunsaturated FAs (2.02 g eicosapentaenoic acid+0.92 g docosahexaenoic acid/day) or an isocaloric control supplement, during multimodality treatment. Quality of life, Karnofsky Performance Status, handgrip strength and physical activity (by wearing an accelerometer) were assessed. Effects of intervention were analysed by generalised estimating equations. P-values <0.05 were regarded as statistically significant.

RESULTS:

The intervention group reported significantly higher on the quality of life parameters, physical and cognitive function (B=11.6 and B=20.7, P<0.01), global health status (B=12.2, P=0.04) and social function (B=22.1, P=0.04) than the control group after 5 weeks. The intervention group showed a higher Karnofsky Performance Status (B=5.3, P=0.04) than the control group after 3 weeks. Handgrip strength did not significantly differ between groups over time. The intervention group tended to have a higher physical activity than the control group after 3 and 5 weeks (B=6.6, P=0.04 and B=2.5, P=0.05).

CONCLUSION:

n-3 Polyunsaturated FAs may beneficially affect quality of life, performance status and physical activity in patients with NSCLC undergoing multimodality treatment.