Dietary omega-3 polyunsaturated fatty acids plus vitamin E restore immunodeficiency and prolong survival for severely ill patients with generalized malignancy: a randomized control trial

Cancer. 1998 Jan 15;82(2):395-402. doi: 10.1002/(sici)1097-0142(19980115)82:2<403::aid-cncr21>;2-1.


Background: The aim of the current prospective, randomized control study was to investigate the effect of dietary omega-3 polyunsaturated fatty acids plus vitamin E on the immune status and survival of well-nourished and malnourished patients with generalized malignancy.

Methods: Sixty patients with generalized solid tumors were randomized to receive dietary supplementation with either fish oil (18 g of omega-3 polyunsaturated fatty acids, PUFA) or placebo daily until death. Each group included 15 well-nourished and 15 malnourished patients. The authors measured total T cells, T-helper cells, T-suppressor cells, natural killer cells, and the synthesis of interleukin-1, interleukin-6, and tumor necrosis factor by peripheral blood mononuclear cells before and on Day 40 of fish oil supplementation. Karnofsky performance status, nutritional state, and survival were also estimated.

Results: The ratio of T-helper cells to T-suppressor cells was significantly lower in malnourished patients. Omega-3 PUFA had a considerable immunomodulating effect by increasing this ratio in the subgroup of malnourished patients. There were no significant differences in cytokine production among the various groups, except for a decrease in tumor necrosis factor production in malnourished cancer patients, which was restored by omega-3 fatty acids. The mean survival was significantly higher for the subgroup of well-nourished patients in both groups, whereas omega-3 fatty acids prolonged the survival of all the patients.

Conclusions: Malnutrition appears to be an important predictor of survival for patients with end stage malignant disease. Omega-3 polyunsaturated fatty acids had a significant immunomodulating effect and seemed to prolong the survival of malnourished patients with generalized malignancy.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Adjuvants, Immunologic / administration & dosage
  • Adjuvants, Immunologic / therapeutic use
  • Critical Illness* / therapy
  • Dietary Supplements*
  • Fatty Acids, Omega-3 / administration & dosage
  • Fatty Acids, Omega-3 / therapeutic use*
  • Female
  • Follow-Up Studies
  • Humans
  • Immunocompromised Host* / drug effects
  • Interleukin-1 / blood
  • Interleukin-6 / blood
  • Karnofsky Performance Status
  • Killer Cells, Natural / drug effects
  • Killer Cells, Natural / pathology
  • Leukocytes, Mononuclear / drug effects
  • Leukocytes, Mononuclear / metabolism
  • Lymphocyte Count
  • Male
  • Middle Aged
  • Neoplasms / complications
  • Neoplasms / physiopathology*
  • Nutrition Disorders / diet therapy
  • Nutrition Disorders / drug therapy
  • Nutrition Disorders / etiology
  • Nutritional Status
  • Placebos
  • Prospective Studies
  • Survival Rate
  • T-Lymphocytes / drug effects
  • T-Lymphocytes / pathology
  • T-Lymphocytes, Helper-Inducer / drug effects
  • T-Lymphocytes, Helper-Inducer / pathology
  • T-Lymphocytes, Regulatory / drug effects
  • T-Lymphocytes, Regulatory / pathology
  • Tumor Necrosis Factor-alpha / metabolism
  • Vitamin E / administration & dosage
  • Vitamin E / therapeutic use*


  • Adjuvants, Immunologic
  • Fatty Acids, Omega-3
  • Interleukin-1
  • Interleukin-6
  • Placebos
  • Tumor Necrosis Factor-alpha
  • Vitamin E