DIETARY OMEGA-3 POLYUNSATURATED FATTY-ACIDS PLUS VITAMIN-E RESTORE IMMUNODEFICIENCY AND PROLONG SURVIVAL FOR SEVERELY ILL PATIENTS WITH GENERALIZED MALIGNANCY - A RANDOMIZED CONTROL TRIAL

BACKGROUND. The aim of the current prospective, randomized control stu dy was to investigate the effect of dietary omega-3 polyunsaturated fa tty acids plus vitamin E on the immune status and survival of well-nou rished and malnourished patients with generalized malignancy. METHODS. Sixty patients with generalized solid tumors were randomized to recei ve dietary supplementation with either fish oil (18 g of omega-3 polyu nsaturated fatty acids, PUFA) or placebo daily until death. Each group included 15 well-nourished and 15 malnourished patients. The authors measured total T cells, T-helper cells, T-suppressor cells, natural ki ller cells, and the synthesis of interleukin-1 interleukin-6, and tumo r necrosis factor by peripheral blood mononuclear cells before and on Day 40 of fish oil supplementation. Karnofsky performance status, nutr itional state, and survival were also estimated. RESULTS. The ratio of T-helper cells to T-suppressor cells was significantly lower in malno urished patients. Omega-3 PUFA had a considerable immunomodulating eff ect by increasing this ratio in the subgroup of malnourished patients. There were no significant differences in cytokine production among th e various groups, except for a decrease in tumor necrosis factor produ ction in malnourished cancer patients, which was restored by omega-3 f atty acids. The mean survival was significantly higher for the subgrou p of well-nourished patients in both groups, whereas omega-3 fatty aci ds prolonged the survival of all the patients. CONCLUSIONS. Malnutriti on appears to be an important predictor of survival for patients with end stage malignant disease. Omega-3 polyunsaturated fatty acids had a significant immunomodulating effect and seemed to prolong the surviva l of malnourished patients with generalized malignancy. (C) 1998 Ameri can Cancer Society.