Echium oil is not protective against weight loss in head and neck cancer patients undergoing curative radio(chemo)therapy: a randomised-controlled trial

Background: Therapy-induced mucositis and dysphagia puts head and neck (H&N) cancer patients at increased risk for developing cachexia. Omega-3 fatty acids (n-3 FA) have been suggested to protect against cachexia. We aimed to examine if echium oil, a plant source of n-3 FA, could reduce weight loss in H&N cancer patients undergoing radio(chemo)therapy with curative intent. Methods: In a double-blind trial, patients were randomly assigned to echium oil (intervention (I) group; 7.5 ml bis in die (b.i.d.), 235 mg/ml α-linolenic acid (ALA) + 95 mg/ml stearidonic acid (SDA) + 79 mg/ml γ-linolenic acid (GLA)) or n-3 FA deficient sunflower oil high oleic (control (C) group; 7.5 ml b.i.d.) additional to standard nutritional support during treatment. Differences in percentage weight loss between both groups were analysed according to the intention-to-treat principle. Erythrocyte FA profile, body composition, nutritional status and quality of life were collected. Results: Ninety-one eligible patients were randomised, of whom 83 were evaluable. Dietary supplement adherence was comparable in both groups (median, I: 87%, C: 81%). At week 4, the I group showed significantly increased values of erythrocyte n-3 eicosapentanoic acid (EPA, 14% vs −5%) and n-6 GLA (42% vs −20%) compared to the C group, without a significant change in n-6 arachidonic acid (AA, 2% vs −1%). Intention-to-treat analysis could not reveal a significant reduction in weight loss related to echium oil consumption (median weight loss, I: 8.9%, C: 7.6%). Also, no significant improvement was observed in the other evaluated anthropometric parameters. Conclusions: Echium oil effectively increased erythrocyte EPA and GLA FAs in H&N cancer patients. It failed however to protect against weight loss, or improve nutritional parameters. Trial registration: ClinicalTrials.gov Identifier NCT01596933

Effect of green tea consumption on RBC morphology, membrane properties and antioxidant status in chronic cigarette smokers

256-263Morbidity and mortality attributed to cigarette smoking is a well-known risk factor for diseases and different type of cancers. Free radicals generated by smoking enter into circulation and interacts with blood constituents and RBC membrane thereby causing pathophysiological changes. Herbal extracts have been reported as anti-oxidant and anti-inflammatory supplements, which attenuates free radical induced oxidative stress, among which green tea (Camellia sinensis) has been reported as the elixir of life due to its innumerable health benefits. The present study investigates the protective effect of green tea consumption against cigarette smoking-induced oxidative stress on RBC morphology, membrane properties. Blood samples were collected from 120 selected human male volunteers categorized into four groups viz., controls, smokers, control volunteers consuming green tea with no habit of smoking and smokers consuming green tea were analyzed. Results of this study showed that significantly altered membrane lipid peroxidation, protein carbonyls, -SH groups, ATPases, individual phospholipids, morphological changes in RBC structure and membrane proteins as evident by SDS-PAGE in smokers. Besides, smokers showed decreased activities of antioxidant status. The adverse changes observed in the above parameters in smokers were preserved upon supplementation of green tea. In conclusion, the presence of phenols, flavonoids and tannins, in particular, catechins in green tea might be responsible for the observed protection against smoking-induced alterations in blood

First-line management of metastatic non-small cell lung cancer: An Indian perspective

Lung cancer has been the most common cancer in the world for several decades. The non-small cell lung cancer (NSCLC) constitutes approximately about 80% of the total cases of lung cancer. Therapeutic interventions in NSCLC have shifted to the target-based approach from histology-based approach, and this has completely changed the face of the management of NSCLC. Developing countries, such as India, have very limited data compiled about the prevalence and treatment practices of lung cancer, despite a large burden of the disease. However, in recent times, there has been a lot of data generated in this regard. This article is an attempt to collate and shine light on the available data for the first-line treatment of NSCLC in India keeping in mind the current standards of care in this area