Immunonutrition improves functional capacities in head and neck and esophageal cancer patients undergoing radiochemotherapy: a randomized clinical trial

Clin Nutr. 2014 Apr;33(2):204-10. doi: 10.1016/j.clnu.2013.06.008. Epub 2013 Jun 20.


Background & aims: Malnutrition is frequent in head and neck (HN) and esophageal cancer patients and aggravated by radiochemotherapy (RCT), increasing morbi-mortality and treatment toxicity. Our goal was to investigate the effect of immunonutrition consisting of an arginine, omega-3 fatty acid, nucleotides-enriched diet on nutritional status, and functional capacity in HN or esophageal cancer patients undergoing RCT.

Methods: 37 patients were randomized in a double-blind clinical trial. 5 days before and until the end of RCT (5-7 weeks), they received either an Immunomodulating Enteral Nutrition (IEN) or an isonitrogenous, isoenergetic Standard Enteral Nutrition (SEN). Anthropometrical parameters, nutritional risk index (NRI), serum albumin, plasma antioxidant capacity, and functional capacity were recorded between the beginning and the end of RCT.

Results: A significant gain in total body weight (+2.1 ± 3.1 kg) was observed in IEN patients. Albuminemia and NRI were improved concomitantly in IEN malnourished patients. Plasma antioxidant capacity was improved (+100 ± 13 μM EqTrolox) in IEN patients. Functional capacity measured by WHO Performance Status and Karnofsky index was maintained in IEN patients but significantly reduced in SEN patients.

Conclusions: These preliminary data show that immunonutrition could improve the nutritional status together with functional capacity in HN and esophageal cancer patients undergoing RCT.

Clinical trial registration: This clinical trial promoted by the University Hospital Center of Clermont-Ferrand has been registered at website under the following reference: NCT00333099.

Keywords: Esophageal cancer; Head and neck cancer; Immunonutrition; Radiochemotherapy.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anthropometry
  • Arginine / administration & dosage
  • Arginine / blood
  • C-Reactive Protein / metabolism
  • Chemoradiotherapy / methods
  • Double-Blind Method
  • Enteral Nutrition / methods*
  • Esophageal Neoplasms / diet therapy*
  • Esophageal Neoplasms / radiotherapy
  • Fatty Acids, Monounsaturated / administration & dosage
  • Fatty Acids, Monounsaturated / blood
  • Fatty Acids, Unsaturated / administration & dosage
  • Fatty Acids, Unsaturated / blood
  • Female
  • Food, Formulated / analysis
  • Head and Neck Neoplasms / diet therapy*
  • Head and Neck Neoplasms / radiotherapy
  • Humans
  • Immunomodulation / physiology
  • Male
  • Middle Aged
  • Nutrition Assessment
  • Nutritional Status
  • Serum Albumin
  • Treatment Outcome


  • Fatty Acids, Monounsaturated
  • Fatty Acids, Unsaturated
  • Serum Albumin
  • C-Reactive Protein
  • Arginine

Associated data