A study of preoperative methionine-depleting parenteral nutrition plus chemotherapy in gastric cancer patients

AIM To investigate the interference ofmethionine.free parenteral nutrition plus 5-Fu（-MetTPN+5-Fu）in gastric cancer cell kineticsand the side effects of the regimen.METHODS Fifteen patients with advancedgastric cancer were randomly divided into twogroups,7 patients were given preoperatively aseven-day course of standard parenteralnutrition in combination with a five-day courseof chemotherapy（sTPN+5-Fu）,while the other8 patients were given methionine-deprivedparenteral nutrition and 5-Fu（-MetTPN+5-Fu）.Cell cycles of gastric cancer and normal mucosawere studied by flow cytometry（FCM）.Bloodsamples were taken to measure the serumprotein,methionine（Met）and cysteine（Cys）levels,and liver and kidney functions.RESULTS As compared with the resultsobtained before the treatment,the percentage ofG0/G1 tumor cells increased and that of S phasedecreased in the-MetTPN+5-Fu group,while thecontrary was observed in the sTPN+5-Fu group.Except that the ALT,AST and AKP levels wereslightly increased in a few cases receiving-MetTPN+5-Fu,all the other biochemicalparameters were within normal limits.Serum Cys level decreased slightly after the treatmentin both groups.Serum Met level of patientsreceiving sTPN+5-Fu was somewhat higher aftertreatment than that before treatment;however,no significant change occurred in the -MetTPN+5-Fu group,nor operative complications in bothgroups.CONCLUSION -MetTPN+5-Fu exerted asuppressive effect on cancer cell proliferation,probably through a double mechanism ofcreating a state of'Met starvation'adverse tothe tumor cell cycle,and by allowing 5-Fu to killspecifically cells in S phase.Preoperative short-term administration of -MetTPN+5-Fu had littleundesirable effect on host metabolism.

Three methods assess nutritional status of leukemia patients before hematopoietic stem cell transplantation

Background Some leukemia patients before hematopoietic stem cell transplantation （HSCT） have nutritional risk or undernutrition,which was one of the main reasons that caused series of complications during transplantation.The aim of this study was to find out some appropriate methods to learn about the nutritional status of leukemia patients before HSCT.Methods Nutritional status of patients with leukemia was assessed with three common methods of nutritional assessment （nutritional risk screening 2002 （NRS2002）,mini nutritional assessment （MNA） and subjective global assessment （SGA）） before HSCT.The assessment results of NRS2002 and MNA were compared by paired x2 test.The consistency was analyzed by Kappa test.Results In this study,13 of 50 patients （26.0%） with leukemia had nutritional risk before HSCT assessed by NRS2002,including 7 patients （14.0%） with undernutrition.Of 50 patients assessed by SGA,only 1 case （2.0%） was mild or moderate undernutrition,and the remaining 49 patients （98.0%） were well-nutrition.Assessed by MNA,1 case （2.0%）was undernutrition,11 cases （22.0%） were potential undernutrition,and 38 cases （76.0%） were well-nutrition.Paired x2 test results showed that the difference between NRS2002 and MNA was statistically significant （x2=13.64,P 〈0.05）;Kappa test results showed that they were consistent between NRS2002 and MNA （Kappa=0.62,P〈0.05）.Conclusions It is important to know the nutritional status of patients with leukemia before HSCT,and NRS2002 should be the first choice of nutritional assessment for patients with leukemia.If NRS2002 and MNA used at the same time,the accuracy and comprehensiveness of the assessment can be improved.

Efficacy of early interdisciplinary palliative care based on WARM model in non-small-cell lung cancer

Objective To assess the therapeutic effect of the early interdisciplinary palliative care based on WARM model(whole,assessment,revaluation,management)on the quality of life,psychological state,pain and nutritional status in patients with non-small-cell lung cancer(NSCLC).Methods A total of 60 patients from Chongqing University Cancer Hospital with newly diagnosed advanced NSCLC from Oct 15,2019 to Jun 12,2020 were enrolled.