Efficacy of Synbiotic Maintenance Dose on Cancer Cachexia in Advanced Nasopharyngeal Cancer: A Randomized Controlled Trial

This study investigated the impact of synbiotics on inflammatory status, anorexia, fatigue, body composition, and functional capacity in patients with advanced Nasopharyngeal Cancer (NPC). This randomized controlled trial included NPC patients aged 20-70 years undergoing chemotherapy without metastasis, acute infection, or concurrent radiotherapy. Participants were recruited via consecutive sampling and randomly assigned to receive synbiotics (comprising 4 probiotic strains and 1 prebiotic) or placebo daily for 42 days. Inflammatory status was assessed through the Neutrophil-Lymphocyte Ratio (NLR) and C-reactive protein (CRP) levels. Fat and muscle mass were measured using a Karada Scan Omron. Anorexia was evaluated with the FAACT-A/CS questionnaire, and fatigue with the FACIT-F questionnaire. Functional capacity was determined through hand grip strength (HGS) using a Camry dynamometer. Data were collected pre and post-intervention and analyzed using an independent t-test (or Mann-Whitney test) for continuous data and chi-square (or Fisher's exact test) for categorical data. Of the 43 patients enrolled, data from 34 patients were analyzed. The initial characteristics of both groups were similar. However, there were no significant differences between the synbiotics and placebo groups at the study's conclusion in terms of NLR (p = 0.64), CRP levels (p = 0.33), anorexia score (p = 0.27), fatigue score (p = 0.31), fat mass (p = 0.92), muscle mass (p = 0.73), and HGS (p = 0.77). Synbiotics did not significantly affect inflammatory status, anorexia and fatigue levels, body composition, nor functional capacity in patients with advanced NPC. PRACTICAL APPLICATIONS: This research examined whether synbiotics could improve health issues such as inflammation, appetite loss, fatigue, and muscle strength in patients with advanced nasopharyngeal cancer. Although the study found no significant benefits, it highlights the importance of assessing the effects of dietary supplements on cancer patients. This information may guide future product development and nutritional recommendations for cancer patients.