Aug 2026· Clinical Nutrition and Metabolism· 0 citations· 22 references
TL;DR
In GC patients after antitumor treatment, the use of a semi-elemental enteral mixture as additional nutrition had advantages over standard polymer mixtures.
Abstract
Background
Radical antitumor treatment for gastric cancer (GC) can lead to chronic diarrhea. Therefore, the choice of enteral formula for nutritional support becomes important.
Aim
To compare the effectiveness of using semi-elemental and standard polymer mixtures in the post discharge period in patients after gastrectomy.
Methods
A retrospective, non-randomized, single-center study included patients with gastric cancer over 18 years old after gastrectomy, completed anticancer treatment, had no progression of the cancer, and had chronic diarrhea. At the initial consultation, patients received dietary advices, as well as recommendations for probiotics, polyenzyme preparations, and sipping (500 ml per day) of semi-elemental or polymeric mixtures at the patient's discretion. After 28 days, the patients were divided into 2 groups depending on the type of mixture they chose. The study group (SG) had patients receiving the semi-elemental mixture, the control group (CG) had patients receiving polymeric mixtures. The dynamics of diarrhea, nutritional and functional status indicators were analyzed. Statistical data processing was performed using the appropriate software package Microsoft Excel 2011. The results are presented as the mean value ± standard deviation. To assess statistical differences, a two-tailed Student's t-test was used.
Results
A total of 113 patients with GC (65 men) were examined. Fifty-five patients took the semi-elemental mixture, and 58 people took various polymer mixtures. After treatment the frequency of defecation was significantly lower in the SG than in the CG (2.05±1.43 vs 2.61±1.46 times, p=0.04). In the SG, body weight, serum concentration of total protein, absolute lymphocyte count were higher than in the CG: 64.23±10.33 vs 63.56±8.6 kg; 68.61±2.37 vs 67.78±4.46 g/l; 2.33±0.4 vs 2.15±0.43*10^9/l, p0.05, respectively. ECOG’s functional status, hand muscle grip, level of anxiety and depression were better in the SG (0.89±0.6 vs 1.17±0.75 points, 33.51±10.09 vs 29.66±9.58 kg, 6.44±1.24 vs 7.09±1.61 points, 8.27±1.62 vs 8.86±1.3 points, p0.05, respectively).
Conclusion
In GC patients after antitumor treatment, the use of a semi-elemental enteral mixture as additional nutrition had advantages over standard polymer mixtures.
This study demonstrates comparable and in some key indicators higher clinical and economic efficiency of domestic enteral nutrition products in perioperative period for cancer patients with nutritional disorders.
D. N. Grekov, S. S. Lebedev, A. M. Mikheeva et al.· Khirurgiia· 0 citations
Background Gastrointestinal (GI) toxicity frequently occurs in patients with locally advanced cervical cancer receiving concurrent chemoradiotherapy, often resulting in severe malnutrition. Purpose This study compared the effects of an anti-inflammatory diet (AID) versus a low-residue diet (LRD) on nutritional status, toxicity, inflammation, and treatment outcomes in women with locally advanced cervical cancer (LACC) undergoing chemoradiotherapy (CRT). Methods In this randomized controlled trial, women with LACC were assigned to either the AID or the LRD. Nutritional status, GI toxicity, inflammation, and tumor response were assessed at five time points, before, during, and after treatment. Results A total of 83 participants completed the study: 41 in the AID group and 42 in the LRD group. The AID group consumed more anti-inflammatory nutrients, and both groups showed nutritional recovery by visit 5, as indicated by Patient-Generated Subjective Global Assessment (PG-SGA) scores and lower rates of undernutrition. Although both groups experienced peak toxicity mid-treatment, the AID group reported fewer persistent GI symptoms by the end, consistent with more stable intestinal inflammation, as evidenced by calprotectin levels. Cytokine analysis showed lower IL-1β and IL-17A levels in the AID group at the final visit. A complete response to treatment was seen in 70.7% of the AID group versus 54.8% in the LRD group (p = 0.133). Overall survival rates were more favorable in the AID group. Conclusion In women with LACC receiving CRT, the anti-inflammatory diet showed a trend toward improved nutritional status, reduced inflammation, and better treatment response. These findings underscore the potential clinical benefits of incorporating personalized, nutrient-rich dietary interventions into supportive oncology care. The study was registered on ClinicalTrials.gov (ID: NCT03994055). Clinical Trial Registration https://clinicaltrials.gov/study/NCT03994055, identifier [NCT03994055]
J. Luvián-Morales, A. Rueda-Escalona, M. Delgadillo-González et al.· Frontiers in Nutrition· 0 citations
Background: Malnutrition is a frequent complication in patients with cancer undergoing chemotherapy due to increased metabolic requirements, treatment-related adverse effects, and infectious complications. Gastrointestinal disturbances such as nausea, dysphagia, and opportunistic infections may worsen food intake and increase the risk of malnutrition.
Case Description: A 66-year-old woman with ascending colon non-Hodgkin lymphoma undergoing the fourth cycle of R-CHOP chemotherapy was hospitalized with pneumonia, oroesophageal candidiasis, suspected pneumonitis, electrolyte disturbances (Na 129 mmol/L; K 3.2 mmol/L), and mild anemia (Hb 9.8 g/dL). Nutritional assessment showed a body mass index of 19.2 kg/m2 with approximately 10.6% weight loss during the chemotherapy period, indicating a risk of malnutrition. Nutritional therapy was provided gradually as a high-energy, high-protein diet with targets of 2100 kcal and 70 g protein/day, in the form of blenderized meals three times daily, together with peptide-based enteral formula supplementation, additional virgin coconut oil, and zinc and vitamin C supplementation.
Discussion: Texture modification was intended to improve oral tolerance and minimize discomfort during swallowing, whereas the peptide-based formula was selected because it may be more easily absorbed when gastrointestinal function is impaired. The addition of virgin coconut oil as a source of medium-chain triglycerides provided energy that is rapidly metabolized without complex emulsification. Zinc and vitamin C supplementation was expected to support immune response, reduce oxidative stress, and accelerate the healing of mucosa inflamed due to infection and chemotherapy-related effects.
Conclusion: A combination of food texture modification, peptide-based formula, and rapidly absorbed energy sources is a rational strategy to maintain nutritional adequacy and prevent worsening nutritional status during chemotherapy.
Keywords: non-Hodgkin lymphoma, chemotherapy, malnutrition, ESPEN
Ni Komang Saraswita Laksmi· Bali Medical and Wellness Jo...· 0 citations
Early postoperative enteral nutrition support can effectively improve the nutritional status of breast cancer patients after neoadjuvant chemotherapy, enhance immune function to a certain extent, and promote postoperative recovery.
W. Lu, X. He, K. Zhang et al.· Zhonghua zhong liu za zhi [C...· 0 citations
Objective: To evaluate whether neoadjuvant therapy can be carried out in pyloric obstruction secondary to gastric cancer through nasojejunal enteral nutrition and assess tumor regression and improvement in surgical outcomes.Material and Methods: A retrospective cohort analysis of patients diagnosed with locally advanced gastric cancer (LAGC) with pyloric obstruction who received preoperative nutritional support via nasojejunal tube feeding. Once nutritional adequacy was achieved, patients proceeded to neoadjuvant therapy consisting of S-1 plus oxaliplatin (SOX chemotherapy), targeted therapy with apatinib, and immunotherapy with sintilimab. Tumor and lymph node responses were assessed radiologically and confirmed by postoperative pathological analysis.Results: Enteral feeding was well tolerated without major complications, and all patients were able to complete the neoadjuvant regimen. Imaging showed dramatic shrinkage of the tumor mass and regression of regional lymph node enlargement. After surgery, certain cases yielded a result of complete tumor regression (Tumor Regression Grade 0) in the pathology, including resolution of lymph node metastases. Clinical results established that nutritional optimization helped in the effective downstaging of tumors and thus improved the chances of R0 resection.Conclusion: Nasoenteric enteral nutrition is a feasible and effective method to enable the safe delivery of neoadjuvant therapy in patients with pyloric obstruction resulting from gastric cancer. It optimizes nutrition, enhances treatment tolerance, and contributes to favorable oncologic outcomes.
Shi Bin, Chenggang Yang, Daogui Yang· Journal of Health Science an...· 0 citations
Background/Aim: The OGSG1108 trial evaluated the effect of oral elemental nutritional supplementation (ONS) on one-year compliance with adjuvant S-1 chemotherapy after gastrectomy for pathological stage II/III gastric cancer. It remains unknown whether intervention with ONS affords survival benefits, along with enhanced compliance with adjuvant chemotherapy. Patients and Methods: Two groups of patients registered in the OGSG1108 trial were compared. The on-protocol group included 81 patients with pathological stage II/III gastric cancer and good acceptability (≥60%) in an ONS compliance test, who were eligible for the second registration and received protocol-based treatment with adjuvant S-1 and ONS. The off-protocol group included 24 patients with pathological stage II/III gastric cancer and poor acceptability (<60%) in an ONS compliance test, who were ineligible for the second registration and received optional adjuvant S-1 as an off-protocol treatment. Supplemental data were collected for both groups. Patient characteristics, biochemical and oncological factors, postoperative complications, number of S-1 chemotherapy courses, overall survival (OS), and relapse-free survival (RFS) were compared and prognostic factors were analyzed. Results: The number of S-1 courses was comparable between the two groups (on-protocol vs. off-protocol: 6.3±2.5 vs. 5.9±3.3). No significant differences were observed in 5-year OS (71.9% vs. 66.7%, p=0.700) or RFS (58.4% vs. 62.5%, p=0.972). A multivariate analysis identified pathological stage and number of S-1 courses as independent prognostic factors, but not acceptability of ONS. Conclusion: Postoperative intervention with ONS did not seem to improve the prognosis of patients receiving adjuvant S-1 treatment. The number of S-1 courses was a prognostic factor.
Y. Yanagimoto, T. Tsujinaka, Junji Kawada et al.· Anticancer Research· 0 citations