Eficacia de la suplementación con omega 3 en pacientes oncológicos: revisión sistemática y metaanálisis (2024)

Autores/as

  • Delfina Bressan OteguiResidencia de Nutrición. Centro de Educación Médica e Investigaciones Clínicas “Norberto Quirno” (CEMIC). Buenos Aires, Argentina.
  • Evelyn Santilli BourseServicio de Alimentación y Dietoterapia. Centro de Educación Médica e Investigaciones Clínicas “Norberto Quirno” (CEMIC). Buenos Aires. Argentina.
  • Juan Sebastian LasaDepartamento de Gastroenterología. Hospital Britanico de Buenos Aires. Buenos Aires, Argentina.

Palabras clave:

ácidos grasos omega-3, quimioterapia, radioterapia, cáncer, malnutrición

Resumen

Introdu

Introducción: el cáncer afecta el estado nutricional de los pacientes, destacando la necesidad de buscar estrategias nutricionales para abordarlo. Objetivo: evaluar la eficacia de la suplementación con aceite o cápsulas de omega 3 a nivel de parámetros nutricionales e inflamatorios de pacientes oncológicos en tratamiento activo. Métodos: se realizó revisión sistemática para identificar ensayos clínicos controlados. El desenlace primario fue el cambio de peso. Se realizó metaanálisis usando software RevMan. Resultados: se incluyeron siete estudios (participantes n=262). La dosis administrada osciló entre 0,60 a 2,45 g y la intervención se extendió entre 45 días y tres meses. Se observó que los pacientes suplementados perdieron menos peso que aquellos no expuestos al omega 3 (Diferencia Estandarizada de Medias (SMD)= 3,99; IC 95,00 % 2,40-5,57), pero no se encontraron diferencias significativas en el índice de masa corporal (IMC) (SMD= 0,73; IC 95,00% -0,11-1,58) ni en los valores de albúmina (SMD= -0,23; IC 95,00 % -0,26-0,71) y proteína C reactiva (PCR) (SMD= -4,01; IC 95,00 % -15,59-7,57). Los resultados están limitados por el número de estudios incluidos y la heterogeneidad de los mismos. Conclusiones: la suplementación con omega 3 mostró aminorar la pérdida de peso de los pacientes oncológicos en tratamiento activo (quimioterapia y/o radioterapia), pero no presentó efectos beneficiosos en el IMC ni en los valores de albúmina y PCR.

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Citas

Organización Mundial de la Salud. Cáncer [Internet]. 2022 (citado 2024 Ago 14). Disponible en: https://www.who.int/es/news-room/fact-sheets/detail/cancer

Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024; 74: 229–63. doi: 10.3322/caac.21834

International Agency for Research on Cancer. World Fact Sheet [Internet]. 2022 (citado 2024 Nov 27). Disponible en: https://gco.iarc.who.int/media/globocan/factsheets/populations/900-world-fact-sheet.pdf

American Society for Parenteral and Enteral Nutrition. Why Nutrition is Important: Adult Patient with Cancer [Internet]. 2020 (citado 2024 Ago 14). Disponible en: https://www.nutritioncare.org/uploadedFiles/Documents/Malnutrition/MAW_2020/Why%20Nutrition%20is%20Important_Adult%20Patient%20with%20Cancer.pdf

Arends J, Baracos V, Bertz H, Bozzetti F, Calder PC, Deutz NEP, et al. ESPEN expert group recommendations for action against cancer-related malnutrition. Clin Nutr. 2017; 36 (5): 1187–96. doi: 10.1016/j.clnu.2017.06.017

Arends J. Malnutrition in cancer patients: Causes, consequences and treatment options. Eur J Surg Oncol. 2024; 50 (5): 107074. doi: 10.1016/j.ejso.2023.107074

Muscaritoli M, Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H, Bozzetti F, et al. ESPEN practical guideline: Clinical nutrition in cancer. Clin Nutr. 2021; 40 (5): 2898-2913. doi: 10.1016/j.clnu.2021.02.005

De las Peñas R, Majem M, Perez-Altozano J, Virizuela JA, E. Cancer, Diz P, et al. SEOM clinical guidelines on nutrition in cancer patients. Clin Transl Oncol. 2019; 21 (1): 87–93. doi: 10.1007/s12094-018-02009-3

Arends J, Strasser F, Gonella S, Solheim TS, Madeddu C, Ravasco P, et al. Cancer cachexia in adult patients: ESMO Clinical Practice Guidelines. ESMO Open. 2021; 6 (3): 100092. doi: 10.1016/j.esmoop.2021.100092

Castellanos TL, Rodríguez DM. El efecto de omega 3 en la salud humana y consideraciones en la ingesta. Rev. chil. nutr. 2015; 42 (1): 90-5. doi:10.4067/S0717-75182015000100012

Luan CW, Yang HY, Tsai YT, Hsieh MC, Chou HH, Chen KS. Prognostic value of C-reactive protein-to-albumin ratio in head and neck cancer: A meta-analysis. Diagnostics (Basel). 2021; 11 (3): 403. doi: 10.3390/diagnostics11030403

Shirakawa T, Makiyama A, Shimokawa M, Otsuka T, Shinohara Y, Koga F, et al. C-reactive protein/albumin ratio is the most significant inflammatory marker in unresectable pancreatic cancer treated with FOLFIRINOX or gemcitabine plus nab-paclitaxel. Sci Rep. 2023; 13 (1): 1-12. doi: 10.1038/s41598-023-34962-7

De Castro GS, Andrade MF, Pinto FCS, Faiad JZ, Seelaender M. Omega-3 fatty acid supplementation and its impact on systemic inflammation and body weight in patients with cancer cachexia—A systematic review and meta-analysis. Front Nutr. 2022; 31 (8): 797513. doi: 10.3389/fnut.2021.797513

Delpino FM, Figueiredo LM. Effects of omega-3 supplementation on lean body mass in cancer patients: a systematic review and meta-analysis. Eur J Clin Nutr. 2022; 76 (12): 1636–45. doi: 10.1038/s41430-022-01100-x

Jin X, Xu XT, Tian MX, Dai Z. Omega-3 polyunsaterated fatty acids improve quality of life and survival, but not body weight in cancer cachexia: A systematic review and meta-analysis of controlled trials. Nutr Res. 2022; 107: 165–78. doi: 10.1016/j.nutres.2022.09.009

Wang Y, Liu R, Chang M, Wei W, Guo Y, Jin Q, et al. Does omega-3 PUFA-enriched oral nutritional intervention benefit cancer patients receiving chemo (radio) therapy? A systematic review and meta-analysis of randomized controlled trials. Crit Rev Food Sci Nutr. 2023; 63 (18): 3081–96. doi: 10.1080/10408398.2021.1984199

Pan L, Zhou Y, Yin H, Hui H, Guo Y, Xie X. Omega-3 polyunsaturated fatty acids can reduce C-reactive protein in patients with cancer: A systematic review and meta-analysis of randomized controlled trials. Nutr Cancer. 2022; 74 (3): 840–51. doi: 10.1080/01635581.2021.1931365

Lam CN, Watt AE, Isenring EA, de van der Schueren MAE, van der Meij BS. The effect of oral omega-3 polyunsaturated fatty acid supplementation on muscle maintenance and quality of life in patients with cancer: A systematic review and meta-analysis. Clin Nutr. 2021; 40 (6): 3815–26. doi: 10.1016/j.clnu.2021.04.031

Guo Y, Ma B, Li X, Hui H, Zhou Y, Li N, et al. n-3 PUFA can reduce IL-6 and TNF levels in patients with cancer. Br J Nutr. 2023; 129 (1): 54–65. doi: 10.1017/S0007114522000575

Hosseini F, Hemmati A, Takabi FS, Naeini F, Shab Bidar S. A dose–response meta-analysis of randomized clinical trials investigating the effects of omega-3 supplementation on body weight in patients with cancer cachexia. Clin Nutr ESPEN. 2024; 59: 378–86. doi: 10.1016/j.clnesp.2023.12.150

Risk of bias tools - Current version of RoB 2 [Internet]. 2019 (citado 2024 Ago 14) . Disponible en: https://www.riskofbias.info/welcome/rob-2-0-tool/current-version-of-rob-2

Luo D, Wan X, Liu J, Tong T. Optimally estimating the sample mean from the sample size, median, mid-range, and/ or mid-quartile range. Stat Methods Med Res. 2018; 27: 1785–1805. doi: 10.1177/0962280216669183

Wan X, Wang W, Liu J, Tong T. Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Med Res Methodol. 2014; 14: 135. doi: 10.1186/1471-2288-14-135

Higgins JP, Li T, Deeks JJ. Choosing effect measures and computing estimates of effect. In: Cochrane Handbook for Systematic Reviews of Interventions. Wiley. 2019: 143–76. doi:10.1002/9781119536604.ch6

Murphy RA, Mourtzakis M, Chu QSC, Baracos VE, Reiman T, Mazurak VC. Nutritional intervention with fish oil provides a benefit over standard of care for weight and skeletal muscle mass in patients with nonsmall cell lung cancer receiving chemotherapy. Cancer. 2011; 117 (8): 1775–82. doi: 10.1002/cncr.25709

Finocchiaro C, Segre O, Fadda M, Monge T, Scigliano M, Schena M, et al. Effect of n-3 fatty acids on patients with advanced lung cancer: a double-blind, placebo-controlled study. Br J Nutr. 2012; 108 (2): 327–33. doi: 10.1017/S0007114511005551

Pastore-Silva JA, Santos de Moraes-Trindade EB, de Souza-Fabre ME, Martorano-Menegotto V, Gevaerd S, da Silva-Buss Z, et al. Fish oil supplement alters markers of inflammatory and nutritional status in colorectal cancer patients. Nutr Cancer. 2012; 64 (2): 267–73. doi:10.1080/01635581.2012.643133

Chagas TR, Borges DS, de Oliveira PF, Mocellin MC, Barbosa AM, Camargo CQ, et al. Oral fish oil positively influences nutritional‐inflammatory risk in patients with haematological malignancies during chemotherapy with an impact on long‐term survival: a randomised clinical trial. J Hum Nutr Diet. 2017; 30 (6): 681–92. doi: 10.1111/jhn.12471

Aredes MA, da Camara AO, de Paula NS, Fraga KYD, do Carmo M das GT, Chaves GV. Efficacy of ω-3 supplementation on nutritional status, skeletal muscle, and chemoradiotherapy toxicity in cervical cancer patients: A randomized, triple-blind, clinical trial conducted in a middle-income country. Nutrition. 2019; 67–68 (110528): 110528. doi: 10.1016/j.nut.2019.06.009

De la Rosa-Oliva F, Meneses-García A, Ruiz-Calzada H, Astudillo-de la Vega H, Bargalló-Rocha E, Lara-Medina F, et al. Effects of omega-3 fatty acids supplementation on neoadjuvant chemotherapy-induced toxicity in patients with locally advanced breast cancer: a randomized, controlled, double-blinded clinical trial. Nutr Hosp. 2019; 36 (4). doi: 10.20960/nh.2338

Cheng M, Zhang S, Ning C, Huo Q. Omega-3 fatty acids supplementation improve nutritional status and inflammatory response in patients with lung cancer: A randomized clinical trial. Front Nutr. 2021; 8. doi: 10.3389/fnut.2021.686752

Aduse-Poku L, Karanth SD, Wheeler M, Yang D, Washington C, Hong Y-R, et al. Associations of total body fat mass and skeletal muscle index with all-cause and cancer-specific mortality in cancer survivors. Cancers (Basel). 2023; 15 (4): 1081. doi: 10.3390/cancers15041081

de Aguiar-Pastore Silva J, Emilia de Souza-Fabre M, Linetzky-Waitzberg D. Omega-3 supplements for patients in chemotherapy and/or radiotherapy: A systematic review. Clin Nutr. 2015; 34 (3): 359–66. doi: 10.1016/j.clnu.2014.11.005

Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019; 48 (1): 16–31. doi: 10.1093/ageing/afy169

Rodríguez-Veintimilla D, Frías-Toral E, Santana-Porbén S. Diagnóstico nutricional en el paciente oncológico: Importancia y Herramientas para realizarla. Oncol (Guayaquil). 2018; 28 (3): 169–80. doi:10.33821/271

Eficacia de la suplementación con omega 3 en pacientes oncológicos: revisión sistemática y metaanálisis (2024)
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