The effect of an elemental diet on oral mucositis of esophageal cancer patients treated with DCF chemotherapy: a multi-center prospective feasibility study (EPOC study)

Yoshihiro Tanaka, Takao Ueno, Naoya Yoshida, Yasunori Akutsu, Hiroya Takeuchi, Hideo Baba, Hisahiro Matsubara, Yuukou Kitagawa, Kazuhiro Yoshida

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose: Oral mucositis (OM) is one of the most uncomfortable adverse events experienced by cancer patients undergoing chemotherapy. Previous reports have revealed that the oral administration of an elemental diet (ED) may prevent OM. However, the incidence of OM has not been accurately determined by specialized diagnostic methods and the effects of an ED on OM remain unclear. We investigated the dose that could feasibly be administered and its effects with regard to the suppression of OM in esophageal cancer patients undergoing chemotherapy. Methods: We performed a prospective multi-center feasibility study of the administration of an ED (160 g/day) with 2 cycles of docetaxel/cisplatin/5-FU (DCF) chemotherapy. We assessed compliance to the ED for 49 days and the incidence of OM according to the amount of the ED that was orally administered. The incidence of OM was graded by a dental specialist who was experienced in dental oncology using a central OM review system. Results: Fourteen of 20 patients (70%) were able to complete the orally administered ED (160 g/day) during the course of chemotherapy. Three patients (15%) could not take the ED orally for 9, 14, and 21 days, respectively, while 1 patient (5%) took the ED orally at an average dose of 80 g/day for 35 days. The remaining 2 patients (10%) could not take the 80 g/day dose for 11 and 12 days, respectively. The incidence of grade ≥ 2 OM in the ED completion group (15.4%, 2 of 13 patients) was significantly lower than that in the non-completion group (66.7%, 4 of 6 patients) (p = 0.046). Conclusions: An ED might be a one of the test treatment to reduce the incidence of OM in esophageal cancer patients treated with DCF and should be evaluated in further randomized study. Clinical trial: The date of submission: Dec 08th, 2017.

Original languageEnglish
Pages (from-to)239-248
Number of pages10
JournalEsophagus
Volume15
Issue number4
DOIs
Publication statusPublished - 2018 Oct 1

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docetaxel
Formulated Food
Stomatitis
Feasibility Studies
Esophageal Neoplasms
Fluorouracil
Cisplatin
Prospective Studies
Drug Therapy
Incidence
Tooth

Keywords

  • Central review system
  • Chemotherapy
  • DCF
  • Esophageal carcinoma
  • Oral mucositis

ASJC Scopus subject areas

  • Gastroenterology

Cite this

The effect of an elemental diet on oral mucositis of esophageal cancer patients treated with DCF chemotherapy : a multi-center prospective feasibility study (EPOC study). / Tanaka, Yoshihiro; Ueno, Takao; Yoshida, Naoya; Akutsu, Yasunori; Takeuchi, Hiroya; Baba, Hideo; Matsubara, Hisahiro; Kitagawa, Yuukou; Yoshida, Kazuhiro.

In: Esophagus, Vol. 15, No. 4, 01.10.2018, p. 239-248.

Research output: Contribution to journalArticle

Tanaka, Yoshihiro ; Ueno, Takao ; Yoshida, Naoya ; Akutsu, Yasunori ; Takeuchi, Hiroya ; Baba, Hideo ; Matsubara, Hisahiro ; Kitagawa, Yuukou ; Yoshida, Kazuhiro. / The effect of an elemental diet on oral mucositis of esophageal cancer patients treated with DCF chemotherapy : a multi-center prospective feasibility study (EPOC study). In: Esophagus. 2018 ; Vol. 15, No. 4. pp. 239-248.
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abstract = "Purpose: Oral mucositis (OM) is one of the most uncomfortable adverse events experienced by cancer patients undergoing chemotherapy. Previous reports have revealed that the oral administration of an elemental diet (ED) may prevent OM. However, the incidence of OM has not been accurately determined by specialized diagnostic methods and the effects of an ED on OM remain unclear. We investigated the dose that could feasibly be administered and its effects with regard to the suppression of OM in esophageal cancer patients undergoing chemotherapy. Methods: We performed a prospective multi-center feasibility study of the administration of an ED (160 g/day) with 2 cycles of docetaxel/cisplatin/5-FU (DCF) chemotherapy. We assessed compliance to the ED for 49 days and the incidence of OM according to the amount of the ED that was orally administered. The incidence of OM was graded by a dental specialist who was experienced in dental oncology using a central OM review system. Results: Fourteen of 20 patients (70{\%}) were able to complete the orally administered ED (160 g/day) during the course of chemotherapy. Three patients (15{\%}) could not take the ED orally for 9, 14, and 21 days, respectively, while 1 patient (5{\%}) took the ED orally at an average dose of 80 g/day for 35 days. The remaining 2 patients (10{\%}) could not take the 80 g/day dose for 11 and 12 days, respectively. The incidence of grade ≥ 2 OM in the ED completion group (15.4{\%}, 2 of 13 patients) was significantly lower than that in the non-completion group (66.7{\%}, 4 of 6 patients) (p = 0.046). Conclusions: An ED might be a one of the test treatment to reduce the incidence of OM in esophageal cancer patients treated with DCF and should be evaluated in further randomized study. Clinical trial: The date of submission: Dec 08th, 2017.",
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T1 - The effect of an elemental diet on oral mucositis of esophageal cancer patients treated with DCF chemotherapy

T2 - a multi-center prospective feasibility study (EPOC study)

AU - Tanaka, Yoshihiro

AU - Ueno, Takao

AU - Yoshida, Naoya

AU - Akutsu, Yasunori

AU - Takeuchi, Hiroya

AU - Baba, Hideo

AU - Matsubara, Hisahiro

AU - Kitagawa, Yuukou

AU - Yoshida, Kazuhiro

PY - 2018/10/1

Y1 - 2018/10/1

N2 - Purpose: Oral mucositis (OM) is one of the most uncomfortable adverse events experienced by cancer patients undergoing chemotherapy. Previous reports have revealed that the oral administration of an elemental diet (ED) may prevent OM. However, the incidence of OM has not been accurately determined by specialized diagnostic methods and the effects of an ED on OM remain unclear. We investigated the dose that could feasibly be administered and its effects with regard to the suppression of OM in esophageal cancer patients undergoing chemotherapy. Methods: We performed a prospective multi-center feasibility study of the administration of an ED (160 g/day) with 2 cycles of docetaxel/cisplatin/5-FU (DCF) chemotherapy. We assessed compliance to the ED for 49 days and the incidence of OM according to the amount of the ED that was orally administered. The incidence of OM was graded by a dental specialist who was experienced in dental oncology using a central OM review system. Results: Fourteen of 20 patients (70%) were able to complete the orally administered ED (160 g/day) during the course of chemotherapy. Three patients (15%) could not take the ED orally for 9, 14, and 21 days, respectively, while 1 patient (5%) took the ED orally at an average dose of 80 g/day for 35 days. The remaining 2 patients (10%) could not take the 80 g/day dose for 11 and 12 days, respectively. The incidence of grade ≥ 2 OM in the ED completion group (15.4%, 2 of 13 patients) was significantly lower than that in the non-completion group (66.7%, 4 of 6 patients) (p = 0.046). Conclusions: An ED might be a one of the test treatment to reduce the incidence of OM in esophageal cancer patients treated with DCF and should be evaluated in further randomized study. Clinical trial: The date of submission: Dec 08th, 2017.

AB - Purpose: Oral mucositis (OM) is one of the most uncomfortable adverse events experienced by cancer patients undergoing chemotherapy. Previous reports have revealed that the oral administration of an elemental diet (ED) may prevent OM. However, the incidence of OM has not been accurately determined by specialized diagnostic methods and the effects of an ED on OM remain unclear. We investigated the dose that could feasibly be administered and its effects with regard to the suppression of OM in esophageal cancer patients undergoing chemotherapy. Methods: We performed a prospective multi-center feasibility study of the administration of an ED (160 g/day) with 2 cycles of docetaxel/cisplatin/5-FU (DCF) chemotherapy. We assessed compliance to the ED for 49 days and the incidence of OM according to the amount of the ED that was orally administered. The incidence of OM was graded by a dental specialist who was experienced in dental oncology using a central OM review system. Results: Fourteen of 20 patients (70%) were able to complete the orally administered ED (160 g/day) during the course of chemotherapy. Three patients (15%) could not take the ED orally for 9, 14, and 21 days, respectively, while 1 patient (5%) took the ED orally at an average dose of 80 g/day for 35 days. The remaining 2 patients (10%) could not take the 80 g/day dose for 11 and 12 days, respectively. The incidence of grade ≥ 2 OM in the ED completion group (15.4%, 2 of 13 patients) was significantly lower than that in the non-completion group (66.7%, 4 of 6 patients) (p = 0.046). Conclusions: An ED might be a one of the test treatment to reduce the incidence of OM in esophageal cancer patients treated with DCF and should be evaluated in further randomized study. Clinical trial: The date of submission: Dec 08th, 2017.

KW - Central review system

KW - Chemotherapy

KW - DCF

KW - Esophageal carcinoma

KW - Oral mucositis

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