Benefits of an anti-inflammatory diet compared to a low-residue diet during concurrent chemoradiation therapy for patients with locally advanced cervical cancer: a randomized clinical trial
TL;DR
In women with LACC receiving CRT, the anti-inflammatory diet showed a trend toward improved nutritional status, reduced inflammation, and better treatment response, which underscores the potential clinical benefits of incorporating personalized, nutrient-rich dietary interventions into supportive oncology care.
Abstract
Background Gastrointestinal (GI) toxicity frequently occurs in patients with locally advanced cervical cancer receiving concurrent chemoradiotherapy, often resulting in severe malnutrition. Purpose This study compared the effects of an anti-inflammatory diet (AID) versus a low-residue diet (LRD) on nutritional status, toxicity, inflammation, and treatment outcomes in women with locally advanced cervical cancer (LACC) undergoing chemoradiotherapy (CRT). Methods In this randomized controlled trial, women with LACC were assigned to either the AID or the LRD. Nutritional status, GI toxicity, inflammation, and tumor response were assessed at five time points, before, during, and after treatment. Results A total of 83 participants completed the study: 41 in the AID group and 42 in the LRD group. The AID group consumed more anti-inflammatory nutrients, and both groups showed nutritional recovery by visit 5, as indicated by Patient-Generated Subjective Global Assessment (PG-SGA) scores and lower rates of undernutrition. Although both groups experienced peak toxicity mid-treatment, the AID group reported fewer persistent GI symptoms by the end, consistent with more stable intestinal inflammation, as evidenced by calprotectin levels. Cytokine analysis showed lower IL-1β and IL-17A levels in the AID group at the final visit. A complete response to treatment was seen in 70.7% of the AID group versus 54.8% in the LRD group (p = 0.133). Overall survival rates were more favorable in the AID group. Conclusion In women with LACC receiving CRT, the anti-inflammatory diet showed a trend toward improved nutritional status, reduced inflammation, and better treatment response. These findings underscore the potential clinical benefits of incorporating personalized, nutrient-rich dietary interventions into supportive oncology care. The study was registered on ClinicalTrials.gov (ID: NCT03994055). Clinical Trial Registration https://clinicaltrials.gov/study/NCT03994055, identifier [NCT03994055]