1
Sichuan Cancer Hospital, Chengdu 610041, China; 2
Peking University Cancer Hospital, Beijing 100142, China; 3
Shanxi Cancer
Hospital, Taiyuan 030013, China; 4
The Fourth Hospital of Hebei Medical University, Shijiazhuang 050035, China; 5
Henan Cancer
Hospital, Zhengzhou 450008, China; 6
Shandong Cancer Hospital, Jinan 250117, China; 7
The First Affiliated Hospital of Zhengzhou
University, Zhengzhou 450052, China; 8
Zhongnan Hospital of Wuhan University, Wuhan 430071, China; 9
Xiangya Hospital Central
South University, Changsha 410008, China; 10Aviation General Hospital / Beijing Institute of Translational Medicine, Chinese
Academy of Sciences, Beijing 100012, China
Abstract：Objective To evaluate the change of body weight, nutritional status, efficacy and safety of concurrent
chemoradiotherapy combined with or without enteral nutrition for esophageal carcinoma. Methods Patients with esophageal
carcinoma in accordance with inclusion criteria were randomly assigned to experimental group and the control group. Both groups of
patients received at least 2 cycles of chemotherapy with cisplatin and docetaxel every 3 weeks concurrent with radiotherapy. Patients
in concurrent chemoradiotherapy experimental group received enteral nutrition containing 10~25kcal/(kg·d) according to swallowing
obstruction, dietary structure, amount of food intake, in addition to regular diets. The primary end point was weight loss and the
secondary end points were nutrition related index, toxicity and clinical effect. Results Between Sep. 2014 and Feb. 2016, 88 patients
were enrolled and divided into the experimental group (n=58) and the control group (n=30). The baseline clinical characteristics of
the 2 groups were similar. The average loss of body weight of experimental group was lower than the control group [(2.26±0.64)kg
vs. (5.45±2.94)kg, P>0.05]. The average loss of body mass index in experimental group was lower than the control group (0.88±0.25
vs. 2.08±1.12, P>0.05). The nutrition related indicators such as hemoglobin, serum albumin, total lymphocyte count of experimental
group were better than the control group, there were no statistical differences except for serum albumin (P>0.05). The objective
remission rate of the experimental group was 90.4%, while the control group was 86.7% (P>0.05). In adverse reactions, experimental
group with equal or greater than grade 3 hematologic adverse reactions were significantly lower than the control group (31.1% vs.
45.7%, P<0.05). The acute radiation esophagitis and acute radiation pneumonia were no statistical differences (P>0.05). Conclusions
Enteral nutrition can reduce the weight loss of esophageal cancer patients during chemoradiotherapy, improve nutritional status and
treatment tolerance, reduce toxicity, but we need to enroll more patients to confirm these results.
