Table 2.

Clinical effects of ω3 PUFA in CRC patients.

ω3 PUFA daily treatment	Surgery	n Subjects	Timing/duration	Chemotherapy	Observed effect	Outcome measures	Reference
1 g DHA + 2 g EPA orally	Yes	148	7 days pre-surgery	No	Potential beneficial effect on local immune function	ω3 PUFA content in the colonic mucosa and muscular layer	(71)
1 g DHA + 2 g EPA orally	Yes	148	7 days pre-surgery	No	Anti-inflammatory effects	Inflammatory markers	(72)
					5-HEPE ↑
					LTB4/%-HETE ↓
1 g DHA + 2 g EPA orally	Yes	148	7 days pre- and 7 days post-surgery	No	No significant difference between group in infectious or non-infectious post-operative complications	Levels of ω3 PUFA into granulocytes	(69)
0.6 g EPA/DHA (fish oil) orally	No	23	63 days	5-FU + irinotecan + folinic acid	Positive modulation of nutritional status. CRP/albumin ↓	Evaluation of nutritional status and inflammatory markers	(77)
0.6 g EPA/DHA (fish oil) orally	No	11	63 days	CAPE + OXA + 5-FU + leucovorin	Improved CRP values, CRP/albumin status, plasma fatty acid profile, and potentially prevented weight loss during treatment	Evaluation of inflammatory markers and nutritional status	(78)
0.6 g EPA/DHA (fish oil) orally	No	30	63 days	Standard chemotherapy	Delayed tumor progression time by enhancing the antineoplastic action of chemotherapy	Evaluation of tumor progression time and CEA values after chemotherapy	(79)
2 g EPA-FFAa orally	Yes	88	Median 30 days pre-operative	No	Preoperative treatment may have prolonged benefit on post-operative overall and disease-free survival	Ki67, CD31, and PGE2 levels. Survival statistical analysis (overall and disease-free survival)	(80)

^aALFA (SLA Pharma AG, Liestel, Switzerland).

5-HEPE, 5-hydroxyeicosatetraenoic acid; LTB4, leukotriene B4; 5-HETE, 5-hydroxyeicosatetraenoic acid; 5-FU, 5-fluorouracil; CAPE, capecitabine (Xeloda); OXA, oxaloplatin; CRP, C reactive protein; CEA, carcinoembryonic antigen; PGE2, prostaglandin E.2.