• Intervention
    Is there a relationship between a brain cancer patient's intake of omega-3 fatty acid-containing supplement to improve tolerance and support recovery from radiation therapy to the brain and the reduction of radionecrosis associated with radiation therapy?
    • Conclusion

      One (1) retrospective cohort study (- quality) found an association between omega-3 fatty acid supplementation and sylimarin supplementation and improved survival and a decrease in the number of radionecrosis associated with stereotactic radiation therapy to the brain in metastatic brain cancer. Further studies are needed.

    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    • Search Plan and Results: EPA/Omega 3 Fatty Acids and Symptoms/Complications 2005
       
    Is there a relationship between an oral and laryngeal cancer patient's postoperative intake of EPA-containing nutritional supplement to improve tolerance and support recovery from surgery, and the reduction of complications associated with surgery?
    • Conclusion

      One positive quality RCT studied post-operative oral and laryngeal cancer patients who had not experienced weight loss in the 3 months before surgery to see if an EPA-enhanced MFS (2 cans for 2.2 g EPA/day) versus an arginine-enhanced MFS for 12 weeks post-operatively would support post-operative recovery. Results for the EPA group included increased weight and increased fat mass and triceps skinfold. No differences were noted for fat-free mass, arm circumference, or rate of infectious complications between groups.  This study was not placebo controlled, and patients were instructed to eat 30 kcal/kg/day, 1.1 g protein/kg/day and exercise which are potentially confounding to the study results. Therefore, further studies are needed to clarify the relationship between EPA's relationship with cancer cachexia and treatment.

       

       

    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    • Search Plan and Results: EPA/Omega 3 Fatty Acids and Symptoms/Complications 2005
       
    Is there a relationship between the use of EPA as a fish oil supplement to the reduction of weight loss associated with pancreatic cancer?
    • Conclusion

      Two small time series (one neutral and one negative quality) had conflicting results on the effectiveness of EPA as fish oil supplement to reduce weight loss in pancreatic cancer patients. The dosage of EPA as a fish oil supplement and length of supplementation varied among the studies. Larger randomized controlled trials are needed. Sample size was small and there were inconsistencies across the studies.

    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    • Search Plan and Results: EPA/Omega 3 Fatty Acids and Symptoms/Complications 2005
       
    Is there a relationship between the use of EPA as a fish oil supplement to the reduction of weight loss in patients associated with advanced cancers?
    • Conclusion

      Five (5) studies had mixed results as to the use of EPA as fish oil supplement and the reduction of weight loss. Three (3) studies (2 + RCTs, 1 – non-randomized trial) found that EPA as fish oil supplement did not have an effect on weight status. Two (2) other studies (1 + before and after study and 1 + RCT) did find EPA as a fish oil supplement to be successful in stabilizing weight in advanced cancer patients. 4/5 studies (2 from each group) are limited by small sample size. In addition, dosing of EPA and length of supplementation was not consistent in these studies. Further trials are needed.

    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    • Search Plan and Results: EPA/Omega 3 Fatty Acids and Symptoms/Complications 2005
       
    Is there a relationship between the consumption of an EPA-containing nutritional supplement and prescribed appetite stimulant to the reduction of weight loss associated with varied cancer patients?
    • Conclusion

      Two (2) studies (1 large, multicenter, + quality RCT and 1 small, non-randomized neutral quality trial) had differing results on the effectiveness of an EPA-containing nutritional supplement (2 cans for 2.2 gm EPA/day) and appetite stimulant in reducing weight loss after four weeks of supplementation. The large, RCT did not find that the EPA-containing nutritional supplement group had any impact on weight status. A placebo-controlled trial should be completed.

    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    • Search Plan and Results: EPA/Omega 3 Fatty Acids and Symptoms/Complications 2005
       
    Is there a relationship between a patient's consumption of EPA-containing medical food supplement to the reduction of weight loss associated with pancreatic cancer?
    • Conclusion

      One large positive quality RCT showed weight stability in both the EPA group and the control group and were not significantly different in a trial of EPA-containing MFS (2 cans for 2.2g EPA per day) for eight weeks. This study was limited by patients not taking the recommended dosage of EPA-containing product. However, two small, non-randomized studies (one – quality non-placebo-controlled, non-blinded longitudinal study; one neutral quality time series) in which patients consumed an EPA-containing MFS (2 cans for 2.2g EPA per day) from three weeks to 7 weeks in length did result in weight stabilization or weight gain in patients with pancreatic cancer. More studies with better compliance and consistent length of EPA-medical food supplementation are needed.   

    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    • Search Plan and Results: EPA/Omega 3 Fatty Acids and Symptoms/Complications 2005