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Radiation therapy in cancer patients causes hematologic abnormalities mainly attributed to an increased inflammatory state induced by radiation toxicity that are observed to be modulated by immunonutrition [1-3]. The objective of this study was to determine the effect of oral supplementation with immunonutrients on cancer patients undergoing radiation therapy on the following hematologic indices: hemoglobin, total WBC, neutrophil, lymphocyte, and platelet counts.
Cancer patients on radiotherapy from 2007 to 2009 were randomly assigned to a study group (n = 24), which received standard diet plus oral supplementation with an immunonutrition regimen (= 200 ml drink given twice per day providing 600 kcal, 40 g protein, eicosapentanoic acid = 2 g, antioxidants (Vit A = 600 μg, Vit C = 75.2 mg, Vit E = 15 mg, B-carotene = 1,500 μg)), and a control group (n = 32), which only had standard diet. The hematologic data - hemoglobin, total WBC count, neutrophil count, lymphocyte count, and platelet count - were taken before and after completion of the prescribed radiation dose. The results were analyzed using either paired or independent-samples t test.
In the study group the blood indices were higher compared with the control group at the end of radiation therapy: hemoglobin in gm% (12.8 >11.8, P = 0.002), total WBC (7,276 >4,877, P = 0.0005), and neutrophil count (5,363 >3,315, P = 0.0007). There were no differences in the lymphocyte and platelet counts. The WBC change in the study group followed a decreasing pattern (-162.5) while in the control group it was an increasing pattern (+1,657). This indicated lesser inflammation in the study group while there was higher inflammation in the control group (P = 0.004).
Oral supplementation with immunonutrients in cancer patients undergoing radiation therapy resulted in lesser hematologic toxic changes in hemoglobin, total WBC, and neutrophil count.