Calorie restriction in cancer patients undergoing chemotherapy: Facts, phantasy or misunderstanding.

BACKGROUND & AIMS: Experimental studies in cancer cell lines and tumour-bearing animals support the concept that a short-period fasting could potentiate the effect of antineoplastic chemotherapy due to a particular metabolic adaptation normal cells whereas cancer cells would remain particularly sensitive to the toxic effects of the therapy. The potential of such approach is actually emphasized by the media but data in humans are very scant and many oncologists fear that peri-chemotherapy fasting might worsen the patient nutritional status. The aim of this review is to focus on the benefits versus the adverse effects of the peri-chemotherapy fasting and to clarify if discrepancy of opinions regarding this approach relies on data from clinical trials or simply on misunderstandings or prejudices. METHODS: We reviewed all the available literature regarding the peri-chemotherapy fasting in cancer patients with a special focus on compliance, adverse event prevalence and tumour response. RESULTS: Seven papers were available for the analysis. All studies included seemingly well-nourished patients and most of them had a breast or a gynaecologic cancer. Almost all concluded for the feasibility of the peri-chemotherapy fasting, with a good patient compliance. Weight loss was always reported but it was generally mild even if sometimes required a nutritional intervention between the cycles of chemotherapy. One RCT reported a better radiological response of the breast cancer at the neoadjuvant chemotherapy. CONCLUSION: Peri-chemotherapy fasting appears a safe procedure in well-nourished patients receiving a short-term chemotherapy. However claims of oncologic benefit are premature and rumors about its efficacy are presently unjustified.

Clinical study of treatment of peri-chemotherapy nausea and vomiting of cancer patients using thalidomide / 肿瘤研究与临床

Objective To explore the therapeutic effects and adverse reactions of thalidomide in the treatment of peri-chemotherapy nausea and vomiting of cancer patients.Methods Total of 70 patients were randomly divided into two groups:the treatment group (38 cases) and the control group (32 cases).The treatment group was treated with thalidomide (oral administration at a dose of 100 mg per night,then dose can be added by 50 mg until the top dose of 200 mg per day).The original will be maintained if they cannot be tolerate of extensive dose.The treatment group was also injected 2mg tropisetron in 30 minutes before chemotherapy.The control group was only injected same dose tropisetron.All cases were examined antiemetic effects and evaluated adverse reactions.Results Nausea and vomiting control rates were 89.5 ％ (34/38) and 68.8 ％ (22/32) respectively in the treatment group and control group respectively with significant difference.The adverse reactions were similar between the two groups.Conclusion Thalidomide joint tropisetron can effectively control the peri-chemotherapy nausea and vomiting,and the adverse reactions can be acceptable.It could improve further indications of the drug.

Clinical Application of Fritillaria thunbergii Miq. Granule in Refractory Acute Leukemia during Perichemotherapy / 中国中医药信息杂志

Objective To translate the findings from fundamental research into clinical application and to evaluate the clinical efficiency and safety of Fritillaria thunbergii Miq. granule as adjunctive means of chemotherapy during peri chemotherapy of refractory acute leukemia. Methods Patients in multiple hospitals were randomly divided into two groups with Fritillaria thunbergii Miq. granule treatment or synchronous control at three days before chemotherapy respectively, according to random approaches for medical treatment. The clinical therapeutic effects were then determined after one course of treatment. Results According to the research project, 138 patients were analyzed statistically, 72 in Fritillaria thunbergii Miq. granule group and 66 in control group. The complete remission rate (CR) of Fritillaria thunbergii Miq. granule group and control group were 36.8% and 25.8% respectively, while the total effects were 77.8% and 53.0%, which was significantly different (P