Oral nutritional supplements containing n-3 polyunsaturated fatty acids affect quality of life and functional status in lung cancer patients during multimodality treatment: an RCT

Randomized, double-blind, parallel-group trial in adults with stage III non-small cell lung cancer undergoing concurrent chemoradiotherapy as part of multimodality treatment. The intervention arm had 20 participants randomized at baseline, with 15 analyzed at 3 weeks and 14 at 5 weeks; the study was conducted at VU University Medical Center Amsterdam in the Netherlands.

Participants in the active arm received 2 cans/day of an oral nutritional supplement containing n-3 polyunsaturated fatty acids (ProSure) by mouth for 5 weeks during chemoradiotherapy. The daily dose provided EPA 2.02 g/day plus DHA 0.92 g/day; the comparator was an isocaloric control supplement (Ensure).

Overall, the n-3 polyunsaturated fatty acid supplement was associated with better quality of life and functional status during multimodality treatment. Compared with control, the intervention improved Karnofsky Performance Status at 3 weeks (B=5.3, P=0.04) and improved several EORTC QLQ-C30 domains by 5 weeks, including global health status (B=12.2, P=0.04), physical function (B=11.6, P<0.01), cognitive function (B=20.7, P<0.01), social function (B=22.1, P=0.04), nausea/vomiting (B=-16.0, P=0.04), and financial problems (B=-9.5, P=0.04). Physical activity day score also improved at weeks 3 and 5 (B=6.6, P=0.04; B=2.5, P=0.05), while handgrip strength did not show a significant benefit (week 3 B=1.8, P=0.15; week 5 B=1.8, P=0.25).

Small single-center trial with only 20 participants in the active arm and notable early attrition in that arm (5 dropouts by 3 weeks), limiting precision and robustness. The intervention period was short (5 weeks), and some outcomes were not improved, including handgrip strength. Physical activity assessment had variable wear time and baseline activity was not reported separately by arm.