臨床腫瘍学: 症例報告

Individualized Nutrition Therapy Combined with Chemotherapy with Excellent Result in Two Patients with Periampullary Adenocarcinoma

Tamara Tuuminen, Pyry Suonsivu, Kaarlo Jaakkola, Ola Brodin, Carlos Fernández Moro, Bengt Isberg, and Mikael Björnstedt

Background and Aims: Within the last decades it has become increasingly evident that prolonged oxidative stress is the leading course of chronic inflammation and is the major trigger of many chronic diseases including cancer. Traditional chemo- or radiotherapy and newly developed targeted- and immunotherapies for cancer treatment still have a limited impact on patients’ survival rate in metastatic diseases and periampullary adenocarcinoma in particular. Among the latter, pancreatic adenocarcinoma is usually diagnosed at advanced incurable stages because of the absence of specific symptoms and biomarkers. Chemotherapy as a palliative treatment in metastatic periampullary adenocarcinoma is toxic leading often to poor quality of life. Malnutrition, inflammation, and loss of muscle mass are frequent in cancer patients. There is an urgent need for improvement of treatment regiments.

Methods: We report two cases of metastatic periampullary adenocarcinoma with a remission for 12 and 6 years. These patients were treated with conventional anti-cancer therapy fortified with individualized targeted nutrition therapy, which they continue. We review the literature and discuss the rationale for individualized nutrition therapy.

Results: Our patients had excellent response to chemotherapy; they could stand high number of chemotherapy courses and had good performance status. Nutrition therapy proved successful in our patients with metastatic periampullary adenocarcinoma who gained additional years of relatively good quality of life. Scientific data reviewed from the contemporary literature as well as our clinical experience indicate a value of individualized nutrition therapy in cancer.

Conclusion: The excellent result of combining chemotherapy and nutrition therapy indicates that such combinations should be studied. In our opinion all the pathways of redox system should be further studied in the search for improved cancer treatment.