The Effect Of High Protein and Calories Milk On Nutrition Status And Blood Parameters In Ovarian Cancer Patients Treating Chemotherapy
Keywords:
Protein, Supplementation, Ovarian cancer, chemotherapyAbstract
Objective: To assess the comparative effect of high protein milk feeding on routine blood parameters and nutritional status in ovarian cancer patients undergoing chemotherapy
Method: This study was a single-blind randomized controlled clinical trial involving 96 samples divided into 2 groups, including interventional group (n = 48) and control group (n = 48). The intervention group patients received additional nutrition in the form of high-protein and high-calorie milk and vitamin B complex supplementation.
Result: In the control group, there was a significant decrease in BMI (p=<0.001),karnofsky scale (p<0.001), platelets (p=0.003), and hemoglobin (p=0.030) and an increase in PG-SGA (p=<0.001) and NLR (p=<0.001). In the nutritional intervention group, there was a significant increase in karnofsky score (p<0.001) and decrease in PG-SGA (p=0.001), BMI (P<0.001) and platelet (p=0.018) values after undergoing chemotherapy. Comparison between groups showed that the nutritional intervention group had significantly lower values of PG-SGA, leukocytes, platelets, NLR, and PLR and significantly higher BMI and karnofsky score than the control group after undergoing a series of chemotherapy.
Conclusion: The high protein milk intervention can improve nutritional status and inflammatory parameters in ovarian cancer patients undergoing chemotherapy.
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Coleman RL, Fleming GF, Brady MF, Swisher EM, Steffensen KD, Friedlander M, et al. Veliparib with First-Line Chemotherapy and as Maintenance Therapy in Ovarian Cancer. New England Journal of Medicine 2019;381. https://doi.org/10.1056/nejmoa1909707.
Chi DS, Berchuck A, Dizon DS, Yashar C. Principles and Practice of Gynecologic Oncology, 7e. Lippincott Williams & Wilkins, a Wolters Kluwer bu; 2017.
Lorusso D, Daniele G. First line ovarian cancer treatment: Scanning the horizon. Crit Rev Oncol Hematol 2021;160. https://doi.org/10.1016/j.critrevonc.2021.103297.
Bhugwandass CS, Pijnenborg JMA, Pijlman B, Ezendam NPM. Effect of chemotherapy on health-related quality of life among early-stage ovarian cancer survivors: A study from the population-based PROFILES registry. Current Oncology 2016;23. https://doi.org/10.3747/co.23.3243.
Nomelini RS, De Carvalho Oliveira LJ, Tavares-Murta BM, Murta EFC. Parameters of blood count and tumor markers: A retrospective analysis and relation to prognostic factors in ovarian cancer. Eur J Gynaecol Oncol 2017;38. https://doi.org/10.12892/ejgo3503.2017.
Gupta D, Lis CG, Vashi PG, Lammersfeld CA. Impact of improved nutritional status on survival in ovarian cancer. Supportive Care in Cancer 2010;18. https://doi.org/10.1007/s00520-009-0670-y.
Qin N, Jiang G, Zhang X, Sun D, Liu M. The Effect of Nutrition Intervention With Oral Nutritional Supplements on Ovarian Cancer Patients Undergoing Chemotherapy. Front Nutr 2021;8. https://doi.org/10.3389/fnut.2021.685967.
de van der Schueren MAE, Laviano A, Blanchard H, Jourdan M, Arends J, Baracos VE. Systematic review and meta-analysis of the evidence for oral nutritional intervention on nutritional and clinical outcomes during chemo(radio)therapy: Current evidence and guidance for design of future trials. Annals of Oncology 2018;29:1141–53. https://doi.org/10.1093/annonc/mdy114.
Sánchez-Lara K, Turcott JG, Juárez-Hernández E, Nuñez-Valencia C, Villanueva G, Guevara P, et al. Effects of an oral nutritional supplement containing eicosapentaenoic acid on nutritional and clinical outcomes in patients with advanced non-small cell lung cancer: RANDOMISED trial. Clinical Nutrition 2014;33. https://doi.org/10.1016/j.clnu.2014.03.006.
Wu Y, Mu J, Cao J, Li D, Dai Y. Research Status and Progress of Nutritional Support Therapy for Ovarian Cancer. Nutr Cancer 2022;74:1519–26. https://doi.org/10.1080/01635581.2021.1957132.
Manikam NRM, Andrijono A, Witjaksono F, Kekalih A, Sunaryo J, Widya AS, et al. Dynamic Changes in Body Composition and Protein Intake in Epithelial Ovarian Cancer Patients Undergoing Chemotherapy: A Preliminary Study. Asian Pacific Journal of Cancer Prevention 2024;25:555–62. https://doi.org/10.31557/APJCP.2024.25.2.555.
Arends J, Baracos V, Bertz H, Bozzetti F, Calder PC, Deutz NEP, et al. ESPEN expert group recommendations for action against cancer-related malnutrition. Clinical Nutrition 2017;36. https://doi.org/10.1016/j.clnu.2017.06.017.
Prado CM, Purcell SA, Laviano A. Nutrition interventions to treat low muscle mass in cancer. J Cachexia Sarcopenia Muscle 2020;11. https://doi.org/10.1002/jcsm.12525.
van de Worp WRPH, Schols AMWJ, Theys J, van Helvoort A, Langen RCJ. Nutritional Interventions in Cancer Cachexia: Evidence and Perspectives From Experimental Models. Front Nutr 2020;7. https://doi.org/10.3389/fnut.2020.601329.
Mirzoev TM, Shenkman BS. Regulation of Protein Synthesis in Inactivated Skeletal Muscle: Signal Inputs, Protein Kinase Cascades, and Ribosome Biogenesis. Biochemistry (Moscow) 2018;83. https://doi.org/10.1134/S0006297918110020.
Boutière M, Cottet-Rousselle C, Coppard C, Couturier K, Féart C, Couchet M, et al. Protein intake in cancer: Does it improve nutritional status and/or modify tumour response to chemotherapy? J Cachexia Sarcopenia Muscle 2023;14:2003–15. https://doi.org/10.1002/jcsm.13276.
Mardas M, Stelmach-Mardas M, Madry R. Body weight changes in patients undergoing chemotherapy for ovarian cancer influence progression-free and overall survival. Supportive Care in Cancer 2017;25:795–800. https://doi.org/10.1007/s00520-016-3462-1.
Johnston EA, Ibiebele TI, Friedlander ML, Grant PT, van der Pols JC, Webb PM. Association of Protein Intake with Recurrence and Survival Following Primary Treatment of Ovarian Cancer. American Journal of Clinical Nutrition 2023;118:50–8. https://doi.org/10.1016/j.ajcnut.2023.05.002.
Macciò A, Madeddu C, Gramignano G, Mulas C, Tanca L, Cherchi MC, et al. The role of inflammation, Iron, And nutritional status in cancer-related anemia: Results of a large, Prospective, Observational study. Haematologica 2015;100. https://doi.org/10.3324/haematol.2014.112813.
Widhiarta KD, Askandar B. The correlation of nutritional status with hematology toxicity of adjuvant chemotherapy in ovarian cancer. Majalah Obstetri & Ginekologi 2021;29:57. https://doi.org/10.20473/mog.v29i22021.57-62.
Winata J, Laihad BJ, M Wagey FM. Preoperative Platelet-Lymphocyte Ratio as a Prognostic Factor of Epithelial Ovarian Cancer Rasio Trombosit-Limfosit Pra Operasi sebagai Faktor Prognostik Epitel Kanker ovarium. Indones J Obstet Gynecol 2023;11.
Hu Q, Hada A, Han L. Platelet count as a biomarker for monitoring treatment response and disease recurrence in recurrent epithelial ovarian cancer. J Ovarian Res 2020;13. https://doi.org/10.1186/s13048-020-00682-z.
Isingizwe ZR, Meelheim BA, Benbrook DM. Elevated Platelet Aggregation in Patients with Ovarian Cancer: More than Just Increased Platelet Count. Cancers (Basel) 2024;16. https://doi.org/10.3390/cancers16213583.
Rosaudyn R, Mutiani F, Yuliati I, Indraprasta BR. Prognostic value of neutrophil-to-lymphocyte ratio and fibrinogen levels in ovarian cancer. Medical Journal of Indonesia 2023;32:86–97. https://doi.org/10.13181/mji.oa.236880.
Zhang C long, Jiang X chen, Li Y, Pan X, Gao M qi, Chen Y, et al. Independent predictive value of blood inflammatory composite markers in ovarian cancer: recent clinical evidence and perspective focusing on NLR and PLR. J Ovarian Res 2023;16. https://doi.org/10.1186/s13048-023-01116-2.
Liontos M, Andrikopoulou A, Koutsoukos K, Markellos C, Skafida E, Fiste O, et al. Neutrophil-to-lymphocyte ratio and chemotherapy response score as prognostic markers in ovarian cancer patients treated with neoadjuvant chemotherapy. J Ovarian Res 2021;14. https://doi.org/10.1186/s13048-021-00902-0.
Xu W, Wang W, Yang M, Song L, Xiong J, Lin J, et al. Prognostic significance of the platelet-to-lymphocyte ratio in ovarian cancer: A meta-analysis. Transl Cancer Res 2018;7:552–60. https://doi.org/10.21037/tcr.2018.05.13.
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