The Effects of Perioperative Supplementation of EPA on Immunosuppression Induced by Postoperative Chemo-radiation Therapy for Esophageal Cancer

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Aim: The effects of or al orenteral administration of eicosapentaenoic acid (EPA) on suppression of the immune function induced by postoperative chemo-radiation therapy in patients with esophageal cancer were studied.<br>Methods: Thirteen patients received TPN, including Intralipid, from 1 week before the operation until 2 weeks after the operation and were then switched to enteral feeding containing 17.5% MCT and 7.5% safflower oil. EPA methyl esther was administered orally at a dose of 1.8g/day with the parenteral or the enteral diet to the “EPA” group (n=5) from 1 week before the operation until discharge. EPA was not given to the “Control” group (n=8). PHA-and ConA-stimulated lymphocyte proliferation, NK activity, and total lymphocyte and T cell counts were measured on admission as well as in the 3rd, 7th, and 10th postoperative weeks. Starting after 3 to 4 postoperative weeks, postoperative chemoradiation therapy (CBDCA 30mg/day, 5-FU 250mg/day, radiation 1.8Gy/day) was performed for 5 consective day each week for 4 to 5 weeks.<br>Results: Both ConA-and PHA-stimmulated lymphocyte proliferation decreased significantly on the 10th postoperative day in both groups. Improvement in cell-mediated immune function in the 3rd postoperative week was marked in the “EPA” group (p<0.01 in PHA and p<0.02 in ConA) when compared to the “Control” group. Improvement in lymphocyte proliferation was higher in the “EPA” group followong the completion of chemoradiation therapy (p<0.005 “EPA” vs. “Contro” in ConA after 10 weeks). NK activity was also higher in the “EPA” group following the completion of chemoradiation therapy (p<0.004 “EPA” vs. “Control” after 10 weeks). There were no significant differences, however, in WBC, total lymphocyte count, and T cell count.<br>Conclusion: The results suggest that enteral/oral EPA reduced immunosuppression induced by postoperative chemo-radiation therapy in patients who underwent an operation for esophageal cancer.

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