|
Back to 2014 Annual Meeting Posters
Prophylactic Effect of Rikkunshito on Body Weight Loss and Malnutrition Accompanied With Anorexia in Esophageal Cancer Patients After Esophagectomy
Masaki Nakamura*, Mikihito Nakamori, Toshiyasu Ojima, Masahiro Katsuda, Takeshi Iida, Keiji Hayata, Shuuichi Matsumura, Tomoya Kato, Junya Kitadani, Makoto Iwahashi, Hiroki Yamaue
Second Department of Surgery, Wakayama Medical University, School of Medicine, Wakayama, Japan
Background: Esophageal cancer patients after esophagectomy will not only be in a malnutrition accompanied with anorexia, but also tend to cause dysfunction of digestion and absorption. Therefore, prophylaxes of body weight loss and malnutrition at an early stage after the operation lead to improvement of patient's quality of life (QOL). Rikkunshito, a traditional Japanese medicine, has been reported to attenuate dyspeptic symptoms and appetite loss after the gastrointestinal surgery, and its effect on ghrelin is attracting the most attention. The purpose of this study was to evaluate the prophylactic effect of rikkunshito on body weight loss and malnutrition accompanied with anorexia in esophageal cancer patients after esophagectomy.
Methods: This study design was a prospective nonrandomized study. Forty patients with esophageal cancer who underwent esophagectomy from April 2011 to August 2012 at Wakayama Medical University Hospital in Japan were enrolled in this study. They were assigned to the following two groups; the control group (n=20) and the rikkunshito group (n=20). Patients in the rikkunshito group received 2.5g of rikkunshito before every meal for 48 weeks after 4 weeks of the surgery. After the 48-week treatments of rikkunshito, we assessed body weight loss, the nutritional parameters (albumin, prealbumin, transferin, acylghrelin, desacylghrelin) and QOL (The Functional Assessment of Cancer Therapy-Esophageal (FACT-E) Scale). The primary endpoint was the rate of body weight loss in two groups after the 48-week treatments. The rate of body weight loss was calculated as follows: %= [(body weight before surgery) - (body weight 4, 13, 26 or 52 weeks after surgery)]/ body weight before surgery x 100. The plasma ghrelin level was expressed as a percentage of the preoperative level.
Results: There were no adverse effects on administration of rikkunshito. In the rikkunshito group, eighteen patients (90%) could take more than two-thirds of the amount of rikkunshito administration for 48 weeks. The rate of body weight loss after the 48-week treatments was significantly lower in the rikkunshito group than in the control group (the rikkunshito group ; 11.8±8.2%, the control group ; 18.0±6.9%, p=0.0161). The acyl-ghrelin level after the 48-week treatments was significantly higher in the rikkunshito group than in the control group (the rikkunshito group ; 131.7±74.5%, the control group ; 75.6±47.5%, p=0.0391). There was no significant difference in the other nutritional parameters and QOL scores between two groups.
Conclusion: Rikkunshito is useful to improve body weight loss and malnutrition in connection with increase of the plasma acyl-ghrelin level for esophageal cancer patients after esophagectomy.
Back to 2014 Annual Meeting Posters
|
