Recommendations Summary
ONC: Head and Neck Cancer: Surgery and Use of EPA-Enhanced Medical Food Supplement 2007
Click here to see the explanation of recommendation ratings (Strong, Fair, Weak, Consensus, Insufficient Evidence) and labels (Imperative or Conditional). To see more detail on the evidence from which the following recommendations were drawn, use the hyperlinks in the Supporting Evidence Section below.
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Recommendation(s)
ONC: Head and neck cancer: Surgery and EPA-enhanced medical food supplement
If the use of an EPA-enhanced MFS is proposed to decrease post-surgical complications (e.g., infections and weight loss) for oral and laryngeal cancer patients, advise inadequate evidence exists to show a benefit. While one study comparing EPA- versus arginine-enhanced MFS found that an EPA supplement led to an increase in weight, there were no differences in fat-free mass or infectious complications.
Rating: Weak
Conditional
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Risks/Harms of Implementing This Recommendation
No potential risks or harms are associated with the application of this recommendation.
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Conditions of Application
No conditions limit the application of this recommendation.
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Potential Costs Associated with Application
Enhanced MFS tend to be higher in cost.
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Recommendation Narrative
- One positive quality RCT (deLuis, Izaola et al, 2005) with post-operative oral and laryngeal cancer patients who had not experienced weight loss in the 3 months before surgery to see if an EPA-containing nutritional supplement (2 cans for 2.2g EPA per day) versus an arginine-containing nutritional supplement for 12 weeks post-operatively would support post-operative recovery. Results for the EPA group included increased weight and increased fat mass and tricep skinfold.
- This study was not placebo controlled, and patients were instructed to eat 30 kcal per kg per day, 1.1g protein per kg per day and exercise, which are potentially confounding to the study results.
- Further studies are needed to clarify EPA's relationship with cachexia and treatment outcomes.
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Recommendation Strength Rationale
- Based on one positive quality RCT, conclusion statement is a Grade III.
