A prospective pilot study of an elemental nutritional supplement for prevention of oral mucositis during S-1 adjuvant chemotherapy for gastric cancer

• Published in: Surgical oncology 2019-06, Vol.29, p.97-101
• Main Authors: Toyomasu, Yoshitaka, Mochiki, Erito, Yanai, Mitsuhiro, Suzuki, Masaki, Yanoma, Toru, Kimura, Akiharu, Kogure, Norimichi, Ogata, Kyoichi, Kuwano, Hiroyuki
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - drug therapy; Adenocarcinoma - pathology; Adult; Age; Aged; Aged, 80 and over; Amino acids; Antimetabolites, Antineoplastic - adverse effects; Body weight; Body weight loss; Cancer; Cancer therapies; Case-Control Studies; Chemotherapy; Clinical trials; Diarrhea; Diarrhea - chemically induced; Diarrhea - epidemiology; Diarrhea - prevention & control; Diet; Disease prevention; Drug Combinations; Elemental diet; Female; Follow-Up Studies; Food, Formulated; Gastrectomy; Gastric cancer; Humans; Incidence; Japan - epidemiology; Male; Medical prognosis; Middle Aged; Mucositis; Nutrition; Nutrition research; Nutritional Support; Oxonic Acid - adverse effects; Patients; Pilot Projects; Prognosis; Prospective Studies; Proteins; S-1 continuation; Stomach Neoplasms - drug therapy; Stomach Neoplasms - pathology; Stomatitis - chemically induced; Stomatitis - epidemiology; Stomatitis - prevention & control; Surgery; Tegafur - adverse effects; Vitamin B; Weight loss; Young Adult
• ISSN: 0960-7404; 1879-3320
• DOI: 10.1016/j.suronc.2019.04.003

Oral mucositis is one of the most common reasons for discontinuation of S-1 adjuvant chemotherapy after radical gastrectomy. Some studies suggest that nutritional support with amino acids may improve oral mucositis. We conducted a prospective, randomized clinical trial of patients who underwent adjuvant chemotherapy for gastric cancer to examine whether an oral elemental diet prevents chemotherapy associated oral mucositis and body weight loss. Patients were randomly assigned to a group consuming Elental® (the treatment group, n = 11) or a control diet group (n = 11). Patients in the treatment group consumed one pack of Elental® per day during adjuvant chemotherapy. The primary endpoint was the presence and grade of oral mucositis. Secondary endpoints included adherence to Elental® based on the doses recorded in a diary, changes in nutrition parameters, and frequency and severity of adverse events. The incidence of oral mucositis was significantly lower in the treatment group (9.1%) than in the control group (27.3%). The median body weight loss in the treatment group was significantly smaller than that in the control group (P = .015). According to Kaplan-Meier estimates the treatment group was significantly associated with high cumulative S-1 continuation rates (log-rank P = .047). We conclude that the amino-acid-rich elemental diet Elental® may be useful as a countermeasure for S-1 adjuvant chemotherapy-induced mucositis. •Elental® prevented oral mucositis induced by adjuvant chemotherapy for gastric cancer.•Elental® ameliorated body weight loss in patients during S-1 adjuvant chemotherapy.•The amino-acid rich elemental diet can affect the continuation of S-1 chemotherapy.