Accompanying nutrient-metabolic therapy tactics for patients with colorectal cancer

L.N. Kostyuchenko¹, M.V. Kostyuchenko², T.N. Kuzmina¹, A.E. Lychkova¹

¹Loginov Moscow Clinical Scientific Center, Moscow

²Pirogov Russian National Research Medical University, Moscow

Accompanying nutritional supplementation (NS) is necessary for the prevention of metabolic complications and their correction, including within the detoxification alimentation. The search for new areas of accompanying nutritional therapy in the complex treatment of colorectal cancer (CRC) is relevant.

Aim: to determine the effectiveness of balanced infusion solution added to the accompanying NS regimen in CRC.

Patients and methods: 57 patients with CRC metastases in the liver, subjected to surgical or combined treatment, were randomly divided into groups: 30 patients received detoxification NS and balanced solution infusions with hepatoprotective action — Remaxol^® (main group), whereas 27 patients received detoxification NS (control group). The following parameters were assessed: nutritional risk according to NRI; hematological intoxication indices; nutritional deficiency according to the criteria of a well-known alimentary-volemic diagnosis (AVD); hepatological parameters (total protein, albumin, bilirubin, ALT, LDH) according to generally accepted methods; intestinal involvement in detoxification by plasma citrulline level and intestinal microbiota activity (according to the volatile fatty acids content in coprofiltrate). In addition, urea and blood creatinine content were studied, as well as blood electrolyte composition, condition severity according to APACHE II, and life quality of according to ECOG. The groups were comparable in the nutritional risk degree and intoxication syndrome severity. Besides, data processing on factorial analysis and the variation statistics method using the Student’s crite rion was performed.

Results: the relationship between homeostasis indices violations and endotoxicosis development in patients with CRC at the stages T_{3 —} T₄, as well as the best detoxification dynamics when using the detoxification nutrition and Remaxol infusion regimen in comparison with detoxification nutrition were revealed.

Conclusion: to remove toxicants, it is advisable to add the well-known detoxification methods with nutritional compounds with detoxifying components — hepatoprotectors. Remaxol^® is an effective medicine in the structure of detoxification programs for the alimentation of patients with CRC.

Keywords: detoxification nutrition, hepatoprotectors, Remaxol, nutritional supplementation.

For citation: Kostyuchenko L.N., Kostyuchenko M.V., Kuzmina T.N., Lychkova A.E. Accompanying nutrient-metabolic therapy tactics for patients with colorectal cancer. RMJ. 2019;6:37–44.