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Omega-3 Fatty Acids for Chemotherapy-Induced Mucositis

5/15/2018 3:07:31 PM
Mucositis is a common side effect of chemotherapeutic drugs used in the treatment of cancer. Almost all patients receiving high-dose chemotherapy and 80% of patients being treated for head and neck cancers experience mucositis. Symptoms include oral ulcers, erythema, edema, bleeding, and severe pain, which can interfere with swallowing, eating, drinking, and talking. Mucositis can also increase the risk of infection and interfere with patients’ ability to tolerate cancer treatments. Analgesics, steroidal agents, antimicrobials, and other therapeutic strategies are used for mucositis, but nontoxic and effective therapies are still needed.
In a study published in 2017 in the journal Wounds, researchers evaluated the efficacy of omega-3 fatty acid supplementation for preventing and treating oral mucositis in patients receiving chemotherapy. Omega-3 fatty acids influence cytokine and prostaglandin production during inflammation, have shown promise in promoting re-epithelialization and wound healing, and are nontoxic. In the present study, omega-3 fatty acids were also deemed not to interfere with the chemotherapeutic agents being used.
The randomized controlled trial included 60 patients with malignant tumors, undergoing chemotherapy treatment for the first time. Chemotherapy drugs included trastuzumab, raltitrexed, vinorelbine, and vincristine. Patients were randomized to take omega-3 fatty acids or placebo twice a day with meals. The omega-3 pearls provided a total of 4000 mg of fish oil per day, 720 mg eicosapentaenoic acid (EPA) per day, and 480 mg docosahexaenoic acid (DHA) per day. The placebo pearls provided corn oil.
The severity of mucositis was significantly lower in the omega-3 group than in the control group at weeks 1 and 2. After 2 weeks, there was no evidence of mucositis in the patients taking omega-3s. The average duration of mucositis in the omega-3 group was 5.5 days (range 4-9 days), compared with durations of 10-16 days in the placebo group. During weeks 2-3, patients in the omega-3 group experienced a significantly better quality of life (p=.01), with less irritation in the oral quality, better ability to eat, sleep, drink, and sleep, and better general health.  
This study had a small sample size and included only patients being treated for breast cancer or leukemia. It is not known whether the results can be generalized to other patient populations. Nevertheless, the results suggest that omega-3 fatty acids offer a promising and safe intervention for the prevention and treatment of chemotherapy-induced mucositis.
Hashemipour MA, Barzegari S, Kakoie S, Aghahi RH. Effects of Omega-3 Fatty Acids Against Chemotherapy-induced Mucositis: A Double-blind Randomized Clinical Trial. Wounds. 2017;29 (12):360-366.

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