NUTRIZIONE ENTERALE DURANTE CHEMIO-RADIOTERAPIA NEL CARCINOMA ESOFAGEO

In an attempt to increase the poor prognosis of patients with esophageal squamous cell carcinoma, many oncologists propose a combined chemotherapy and radiation therapy approach. In these patients drug-related dysphagia, anorexia and vomiting often lead to malnutrition. The aim of this study is to investigate the efficacy of enteral nutrition during a pre-operative combined chemoradiotherapy. We analyzed 37 malnourished patients divided into two groups: group I (CTR) patients without dysphagia and no nutritional support, group II (NE) patients with dysphagia supported by enteral feeding. Oncological therapies included 5-florouracil (1g/m2/day, dl-4) cisplatin (100mg/m2, dl) for two cycles associated with radiotherapy (30 Gy). We have evaluated the feasibility of enteral nutrition and its effects on the nutritional status and treatment tolerance. Tube feeding was delivered for a mean period of 33 days providing 37 Cal/kg/day and 2.1 g proteins/kg/day. Five patients stopped enteral nutrition before the end of oncological treatment because of an improvement of dysphagia. Nutritional evaluations demonstrated that during the chemoradiation therapy period, the CTR group had an impairment of body weight, total protein and albumin while there was no change in the NE group. No difference in the treatment tolerance between the two groups was found. Our study demonstrates that enteral nutrition is an easy way to prevent deterioration of nutritional status during chemoradiation therapy. Dysphagia is useful for indicating nutritional support.