TR202002698A2 - Nutritional compositions for cancer patients undergoing chemotherapy and/or radiotherapy and/or pre-post surgery - Google Patents
Nutritional compositions for cancer patients undergoing chemotherapy and/or radiotherapy and/or pre-post surgeryInfo
- Publication number
- TR202002698A2 TR202002698A2 TR2020/02698A TR202002698A TR202002698A2 TR 202002698 A2 TR202002698 A2 TR 202002698A2 TR 2020/02698 A TR2020/02698 A TR 2020/02698A TR 202002698 A TR202002698 A TR 202002698A TR 202002698 A2 TR202002698 A2 TR 202002698A2
- Authority
- TR
- Turkey
- Prior art keywords
- vitamin
- composition according
- mcg
- oil
- source
- Prior art date
Links
- 239000000203 mixture Substances 0.000 title claims abstract description 96
- 206010028980 Neoplasm Diseases 0.000 title claims abstract description 43
- 201000011510 cancer Diseases 0.000 title claims abstract description 41
- 235000016709 nutrition Nutrition 0.000 title claims abstract description 36
- 238000002512 chemotherapy Methods 0.000 title claims abstract description 14
- 238000001959 radiotherapy Methods 0.000 title claims abstract description 14
- 238000001356 surgical procedure Methods 0.000 title claims abstract description 13
- 108090000623 proteins and genes Proteins 0.000 claims abstract description 29
- 102000004169 proteins and genes Human genes 0.000 claims abstract description 28
- 229940088594 vitamin Drugs 0.000 claims abstract description 26
- 229930003231 vitamin Natural products 0.000 claims abstract description 26
- 235000013343 vitamin Nutrition 0.000 claims abstract description 26
- 239000011782 vitamin Substances 0.000 claims abstract description 26
- 150000001720 carbohydrates Chemical class 0.000 claims abstract description 14
- 239000000835 fiber Substances 0.000 claims abstract description 10
- 239000007788 liquid Substances 0.000 claims abstract description 10
- 229910052500 inorganic mineral Inorganic materials 0.000 claims abstract description 8
- 239000011707 mineral Substances 0.000 claims abstract description 8
- 235000018102 proteins Nutrition 0.000 claims description 27
- 229920002477 rna polymer Polymers 0.000 claims description 25
- MBMBGCFOFBJSGT-KUBAVDMBSA-N all-cis-docosa-4,7,10,13,16,19-hexaenoic acid Chemical compound CC\C=C/C\C=C/C\C=C/C\C=C/C\C=C/C\C=C/CCC(O)=O MBMBGCFOFBJSGT-KUBAVDMBSA-N 0.000 claims description 18
- 150000003722 vitamin derivatives Chemical class 0.000 claims description 17
- 229930003316 Vitamin D Natural products 0.000 claims description 16
- QYSXJUFSXHHAJI-XFEUOLMDSA-N Vitamin D3 Natural products C1(/[C@@H]2CC[C@@H]([C@]2(CCC1)C)[C@H](C)CCCC(C)C)=C/C=C1\C[C@@H](O)CCC1=C QYSXJUFSXHHAJI-XFEUOLMDSA-N 0.000 claims description 16
- OVBPIULPVIDEAO-LBPRGKRZSA-N folic acid Chemical compound C=1N=C2NC(N)=NC(=O)C2=NC=1CNC1=CC=C(C(=O)N[C@@H](CCC(O)=O)C(O)=O)C=C1 OVBPIULPVIDEAO-LBPRGKRZSA-N 0.000 claims description 16
- 235000019166 vitamin D Nutrition 0.000 claims description 16
- 239000011710 vitamin D Substances 0.000 claims description 16
- 150000003710 vitamin D derivatives Chemical class 0.000 claims description 16
- 229940046008 vitamin d Drugs 0.000 claims description 16
- 235000019197 fats Nutrition 0.000 claims description 14
- 235000014633 carbohydrates Nutrition 0.000 claims description 13
- 238000011282 treatment Methods 0.000 claims description 13
- GVJHHUAWPYXKBD-UHFFFAOYSA-N (±)-α-Tocopherol Chemical compound OC1=C(C)C(C)=C2OC(CCCC(C)CCCC(C)CCCC(C)C)(C)CCC2=C1C GVJHHUAWPYXKBD-UHFFFAOYSA-N 0.000 claims description 12
- CIWBSHSKHKDKBQ-JLAZNSOCSA-N Ascorbic acid Chemical compound OC[C@H](O)[C@H]1OC(=O)C(O)=C1O CIWBSHSKHKDKBQ-JLAZNSOCSA-N 0.000 claims description 12
- XEEYBQQBJWHFJM-UHFFFAOYSA-N Iron Chemical compound [Fe] XEEYBQQBJWHFJM-UHFFFAOYSA-N 0.000 claims description 12
- JAZBEHYOTPTENJ-JLNKQSITSA-N all-cis-5,8,11,14,17-icosapentaenoic acid Chemical compound CC\C=C/C\C=C/C\C=C/C\C=C/C\C=C/CCCC(O)=O JAZBEHYOTPTENJ-JLNKQSITSA-N 0.000 claims description 11
- 235000020673 eicosapentaenoic acid Nutrition 0.000 claims description 11
- 229960005135 eicosapentaenoic acid Drugs 0.000 claims description 11
- JAZBEHYOTPTENJ-UHFFFAOYSA-N eicosapentaenoic acid Natural products CCC=CCC=CCC=CCC=CCC=CCCCC(O)=O JAZBEHYOTPTENJ-UHFFFAOYSA-N 0.000 claims description 11
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- YBJHBAHKTGYVGT-ZKWXMUAHSA-N (+)-Biotin Chemical compound N1C(=O)N[C@@H]2[C@H](CCCCC(=O)O)SC[C@@H]21 YBJHBAHKTGYVGT-ZKWXMUAHSA-N 0.000 claims description 9
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- OVBPIULPVIDEAO-UHFFFAOYSA-N N-Pteroyl-L-glutaminsaeure Natural products C=1N=C2NC(N)=NC(=O)C2=NC=1CNC1=CC=C(C(=O)NC(CCC(O)=O)C(O)=O)C=C1 OVBPIULPVIDEAO-UHFFFAOYSA-N 0.000 claims description 8
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- HCHKCACWOHOZIP-UHFFFAOYSA-N Zinc Chemical compound [Zn] HCHKCACWOHOZIP-UHFFFAOYSA-N 0.000 claims description 7
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- VEXZGXHMUGYJMC-UHFFFAOYSA-M Chloride anion Chemical compound [Cl-] VEXZGXHMUGYJMC-UHFFFAOYSA-M 0.000 claims description 6
- RYGMFSIKBFXOCR-UHFFFAOYSA-N Copper Chemical compound [Cu] RYGMFSIKBFXOCR-UHFFFAOYSA-N 0.000 claims description 6
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- DGAQECJNVWCQMB-PUAWFVPOSA-M Ilexoside XXIX Chemical compound C[C@@H]1CC[C@@]2(CC[C@@]3(C(=CC[C@H]4[C@]3(CC[C@@H]5[C@@]4(CC[C@@H](C5(C)C)OS(=O)(=O)[O-])C)C)[C@@H]2[C@]1(C)O)C)C(=O)O[C@H]6[C@@H]([C@H]([C@@H]([C@H](O6)CO)O)O)O.[Na+] DGAQECJNVWCQMB-PUAWFVPOSA-M 0.000 claims description 6
- ZLMJMSJWJFRBEC-UHFFFAOYSA-N Potassium Chemical compound [K] ZLMJMSJWJFRBEC-UHFFFAOYSA-N 0.000 claims description 6
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- WIGCFUFOHFEKBI-UHFFFAOYSA-N gamma-tocopherol Natural products CC(C)CCCC(C)CCCC(C)CCCC1CCC2C(C)C(O)C(C)C(C)C2O1 WIGCFUFOHFEKBI-UHFFFAOYSA-N 0.000 claims description 6
- 229910052742 iron Inorganic materials 0.000 claims description 6
- DFPAKSUCGFBDDF-UHFFFAOYSA-N nicotinic acid amide Natural products NC(=O)C1=CC=CN=C1 DFPAKSUCGFBDDF-UHFFFAOYSA-N 0.000 claims description 6
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- 239000011591 potassium Substances 0.000 claims description 6
- 229910052700 potassium Inorganic materials 0.000 claims description 6
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- 229940080237 sodium caseinate Drugs 0.000 claims description 6
- KYMBYSLLVAOCFI-UHFFFAOYSA-N thiamine Chemical compound CC1=C(CCO)SCN1CC1=CN=C(C)N=C1N KYMBYSLLVAOCFI-UHFFFAOYSA-N 0.000 claims description 6
- 229960003495 thiamine Drugs 0.000 claims description 6
- 235000019154 vitamin C Nutrition 0.000 claims description 6
- 239000011718 vitamin C Substances 0.000 claims description 6
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- 239000011709 vitamin E Substances 0.000 claims description 6
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 claims description 6
- FYYHWMGAXLPEAU-UHFFFAOYSA-N Magnesium Chemical compound [Mg] FYYHWMGAXLPEAU-UHFFFAOYSA-N 0.000 claims description 5
- 229920002774 Maltodextrin Polymers 0.000 claims description 5
- 239000005913 Maltodextrin Substances 0.000 claims description 5
- AUNGANRZJHBGPY-SCRDCRAPSA-N Riboflavin Chemical compound OC[C@@H](O)[C@@H](O)[C@@H](O)CN1C=2C=C(C)C(C)=CC=2N=C2C1=NC(=O)NC2=O AUNGANRZJHBGPY-SCRDCRAPSA-N 0.000 claims description 5
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Abstract
Mevcut buluş, kemoterapi ve/veya radyoterapi alan ve/veya cerrahi öncesi ve sonrası kanserli hastalara besin desteği sağlayan, en az bir nükleobaz kaynağıyla kombinasyon halinde protein, karbonhidrat, yağ, lif, vitamin ve mineral içeren sıvı kompozisyonlarla ilgilidir.The present invention relates to liquid compositions containing protein, carbohydrate, fat, fiber, vitamins and minerals in combination with at least one source of nucleobases, which provide nutritional support to cancer patients receiving chemotherapy and/or radiotherapy and/or pre and post surgery.
Description
Tarifname KEMOTERAPI VENEYA RADYOTERAPI ALAN VEIVEYA CERRAHI ÖNCESI VE SONRASI KANSERLI HASTALARA YÖNELIK BESIN KOMPOZISYONLARI Teknik Alan Mevcut bulus, kemoterapi ve/veya radyoterapi alan ve/veya cerrahi öncesi ve sonrasi kanserli hastalara besin destegi saglayan sivi kompozisyonlarla ilgilidir.Teknigin Bilinen Durumu Günümüzde kanser tüm dünyada ölümlerin önde gelen nedenlerinden biridir ve hem gelismis hem de gelismekte olan ülkelerde yeni vakalarin sayisi hizla artmaktadir. Kanser dünya genelinde ölüm nedenleri arasinda ikinci siradadir. Dünya Saglik Örgütüne (DSÖ) göre, 2018 yilinda dünya genelinde 18.1 milyon yeni kanser vakasi görülmüs ve 9.6 milyon kisi kanserden ölmüstür. Buna ragmen, erken tani ve tibbi tedavilerdeki gelismeler sayesinde kanserden kurtulanlarin sayisi da önemli ölçüde artmistir. Bununla birlikte, kanserli hastalarin çogu gida aliminin azalmasi, duygusal stres ve tümörle iliskili metabolik degisimler nedeniyle malnütrisyon ve yüksek kilo kaybi yasamaktadir. Kanserli hastalarda beslenme durumu basarili tedavinin ve yasam kalitesinin (QoL) önemli bir belirleyicisidir. Kanser tedavisinden kaynaklanan advers olaylar da malnütrisyona ve kanser tedavilerinde gecikmeye katkida bulunmakta olup, hastalarin büyük bir kisminda kanser nedeniyle ölüme de katkida bulunabilir. Çogu hastada kanserin ve kanser tedavilerinin etkileri de yemek yemeyi zorlastirmaktadir.Beslenmeyi etkileyen kanser tedavileri içerisinde kök hücre nakli, kemoterapi, hormon terapisi, radyasyon terapisi, cerrahi ve immünoterapi bulunmaktadir. Kansertedavisinden özellikle bas, boyun, özofagus, mide, bagirsaklar, pankreas veya karaciger etkilendiginde saglikli kalmak için gerekli besinleri almak zor hale gelmektedir. Beslenme, gidalarin alindigi ve vücut tarafindan büyüme, saglikli kalma ve doku yenileme için kullanildigi prosestir. Iyi beslenme saglik için önemlidir. Kanser tedavisi öncesi, sirasi ve sonrasinda dogru türde yiyecekleri yemek hastanin daha iyi hissetmesine ve daha güçlü kalmasina yardimci olabilir. Ayrica, kanser ve kanser tedavileri tat alma, koku alma ve istahin yani sira yeterli miktarda gida alma veya yemeklerden besinlerin emilimini saglama kabiliyetini etkileyebilir. Bunun sonucunda da önemli besinlerin eksikliginden kaynaklanan bir hastalik olan malnütrisyon görülebilir. Malnütrisyon hastanin güçsüz ve yorgun olmasina, enfeksiyonla savasamamasina veya kanser tedavisini tamamlayamamasina neden olabilir. Kanser ilerlediginde veya yayildiginda malnütrisyon daha da kötülesebilir. Iyilesmek, enfeksiyonla savasmak ve yeterli enerjiye sahip olmak için dogru miktarda protein ve günlük kalori ihtiyacinin alinmasi önemlidir. Vücut büyümek, dokulari onarmak ve bagisiklik sistemini saglikli tutmak için proteine ihtiyaç duyar. Özellikle kanserli hastalar, çogunlukla normalden daha fazla proteine ihtiyaç duyar.Cerrahi islem, kemoterapi veya radyasyon terapisi sonrasinda genellikle dokulari onarmak ve enfeksiyonla savasmaya yardimci olmak açisindan fazladan protein ihtiyaci ortaya çikar.Vücut yeterli protein almadiginda, ihtiyaci olan enerjiyi elde etmek için kas yikimina sebep olabilir. Bunun sonucunda, hastaligin iyilesmesi daha uzun sürecek ve enfeksiyon direnci düsebilecektir. Diger yandan, piyasada birçok yüksek proteinli sivi veya yari sivi nütrisyon kompozisyonu mevcuttur. Nütrisyon kompozisyonlari vücudun ihtiyaci olan besinlerin alinmasini saglar. Bu besinler içerisinde proteinler, yaglar, karbonhidratlar, su, vitaminler ve mineraller bulunmaktadir. Bununla birlikte, teknigin bilinen durumunda, kanser hastalarinda biyokimyasal reaksiyonlarin katalize edilmesi, hücresel sinyallere yanit verilmesi, gen ekspresyonunun düzenlenmesi, proteinlerin sentezlenmesi ve hücrelerin hizla büyümesine yardimci olunmasi açisindan bu bilesenlere ek olarak özellikle RNA içeren nütrisyon kompozisyonu yoktur. Patent literatüründe de, özel olarak farkli yas araliklari ve farkli amaçlar için formüle edilmis nütrisyon kompozisyonlari mevcuttur. Bu kompozisyonlar yetersiz beslenme için takviye olarak veya eksiksiz bir besin kaynagi olarak kullanilabilir. Örnegin, EP0756827B1 numarali patentte, özellikle bagisiklik fonksiyonlarinin bozuldugu veya tümörü olan hastalar için proteinler ve/veya protein hidrolizatlari, karbonhidratlar, lipidler, hacim arttiricilar (bulkage) ve su içeren nütrisyon kompozisyonu ortaya konmaktadir. Teknigin bilinen durumundaki nütrisyon kompozisyonlari protein, yag, karbonhidrat, su, vitamin, mineral ve ribonükleik asit içermektedir. Fakat bu kompozisyonlar, kanser hastalarinin ihtiyaç duydugu gidalari gerekli oranlarda içeren kompozisyonlar degildir. Teknigin bilinen durumu göz önünde bulunduruldugunda, kemoterapi ve/veya radyoterapi alan ve/veya cerrahi öncesi ve sonrasi kanserli hastalar için özel olarak hazirlanmis, vücudu saglikli tutmaya, hasarli dokulari onarmaya, biyokimyasal reaksiyonlari katalize etmeye, protein sentezlemeye ve hücrelerin hizla çogalmasina yardimci olacak ve ayni zamanda sedimentasyon ile oksidasyonu es zamanli olarak azaltmak suretiyle stabiliteyi arttiracak, eksiksiz ve dengeli beslenme saglayan nütrisyon kompozisyonlarina ihtiyaç vardir. Hastalik, tedavi veya iyilesme dönemlerinde günlük kalori ve protein ihtiyaci normalden daha fazla olabilir. Mevcut bulusun isiginda veya mevcut bulusun uygulanmasi yoluyla, baska avantajlar veya farkli sorunlar için çözümler de ortaya çikabilir. Bulusun Amaçlari ve Kisa Açiklamasi Mevcut bulus, kemoterapi ve/veya radyoterapi alan ve/veya cerrahi öncesi ve sonrasi kanserli hastalara besin destegi saglayan sivi kompozisyonlarla ilgilidir. Mevcut bulusun bir amaci, sedimentasyonu ve oksidasyonu ayni anda azaltarak stabiliteyi arttiran nütrisyon kompozisyonlarinin elde edilmesidir. Mevcut bulusun bir diger amaci, ozmolarite ve ozmolalitenin azaltilmis oldugu, ve dolayisiyla hasta uyumunu arttiran nütrisyon kompozisyonlarinin elde edilmesidir. Mevcut bulusun baska bir amaci, hastanin günlük enerji ihtiyacini karsilayacak sekilde dengeli bir karbonhidrat içerigine sahip, glukoz içermeyen nütrisyon kompozisyonlarinin elde edilmesidir. Mevcut bulusun bir diger amaci, fazlalik veya kompetitif emilim olmaksizin biyouyumlu bilesenler içeren nütrisyon kompozisyonlarinin elde edilmesidir. Mevcut bulusun baska bir amaci, esasen su, en az bir protein kaynagi, en az bir karbonhidrat kaynagi, en az bir yag kaynagi, en az bir lif kaynagi, vitamin ve mineral içeren nütrisyon kompozisyonlarinin elde edilmesidir. Mevcut bulusun baska bir amaci, biyokimyasal reaksiyonlari katalize etmek, hücresel sinyallere yanit vermek, gen ekspresyonunu düzenlemek, protein sentezlemek ve hücrelerin hizli çogalmasina yardimci olmak için bir nükleobaz kaynagi içeren nütrisyon kompozisyonlarinin elde edilmesidir.Mevcut bulusun baska bir amaci, bagisiklik ve sinir sistemi, beyin ve kemik sagligini desteklemek için D vitaminiyle kombinasyon halinde bir nükleobaz kaynagi içeren nütrisyon kompozisyonlarinin elde edilmesidir. Mevcut bulusun bir diger amaci, midesi ve bagirsagi hassas olan kanserli hastalarda gastrointestinal sistemi korumak için laktoz içermeyen nütrisyon kompozisyonlarinin elde edilmesidir. Mevcut bulusun bir diger amaci, gastrointestinal sistemi destekleyecek sekilde yüksek lif oranina sahip nütrisyon kompozisyonlarinin elde edilmesidir. Mevcut bulusun baska bir amaci, düsük ozmolarite ve sedimentasyon saglamak amaciyla protein kaynagi olarak spesifik araliklarda kazeinat içeren nütrisyon kompozisyonlarinin elde edilmesidir. Mevcut bulusun baska bir amaci, oksidasyonu azaltmak ve kokuyu gidermek amaciyla kapsül formunda dokosahekzaenoik asit ve eikosapentaenoik asit içeren nütrisyon kompozisyonlarinin elde edilmesidir. Mevcut bulusun bir diger amaci, homojenizasyonu arttirmak ve oksidasyonu azaltmak amaciyla bu tür kompozisyonlarin hazirlanmasi için bir proses gelistirilmesidir. Bulusun Ayrintili Açiklamasi Yukarida belirtilen amaçlara uygun olarak, mevcut bulusun ayrintili özellikleri burada verilmektedir. Mevcut bulus, kemoterapi ve/veya radyoterapi alan ve/veya cerrahi öncesi ve sonrasi kanserli hastalara besin destegi saglayan sivi kompozisyonlarla ilgili olup, bu kompozisyon asagidakileri içermektedir: - sodyum kazeinat ve kalsiyum kazeinat veya bunlarin karisimlarini içeren gruptan seçilen en az bir protein kaynagi, - en az bir karbonhidrat kaynagi, - en az bir yag kaynagi, - en az bir lif kaynagi, - vitaminler, - mineraller, ve kompozisyon ayrica D vitamini ile kombinasyon halinde en az bir nükleobaz kaynagi içermekte olup, bahsedilen nükleobaz kaynaginin D vitaminine orani agirlikça 1:0.00007 ile Bir uygulamada, bahsedilen nükleobaz kaynagi ribonükleik asit (RNA) alt birimleri, polimerik RNA formlari, maya RNA'si veya bunlarin kombinasyonlarini içeren gruptan seçilmektedir. Tercih edilen uygulamaya göre, bahsedilen nükleobaz kaynagi RNA'dir.RNA, vücut tarafindan üretilebilen kimyasal bir bilesiktir. RNA ayni zamanda laboratuvarda da üretilebilir. RNA ilaç olarak veya saglik için takviye olarak kullanilmaktadir. RNA ayni zamanda çok hücreli organizmalarda biyokimyasal reaksiyonlari katalize etmek, hücresel sinyallere yanit vermek, gen ekspresyonunu düzenlemek, protein sentezlemek ve hücrelerin hizli çogalmasina yardimci olmak gibi birçok fonksiyona sahiptir. Ek olarak, ameliyat sonrasi erken dönemde RNA immün yaniti iyilestirir ve cerrahi travma, kemoterapi ve radyoterapi sonrasinda zayiflayan bagisiklik sistemini daha hizli toparlamaya yardimci olur. Çok hücreli organizmalar da RNA ile protein sentezlemektedir. Saglik için takviye olarak alinan RNA'nin esas önemi, hücrelerin hizli çogalmasina yardimci olma kabiliyetiyle ilgilidir. Özellikle cerrahi, kemoterapi, radyoterapi, yaralanma ve bagisiklik sistemine saldiri olan durumlarda RNA'nin bu özelligi çok faydalidir. Tüm bu nedenlerden dolayi, kemoterapi ve/veya radyoterapi alan ve/veya cerrahi öncesi ve sonrasi kanserli hastalarda RNAtakviyesi büyük önem teskil etmektedir. Bulusun en çok tercih edilen uygulamasina göre, kompozisyonda nükleobaz kaynagi olarak bulunan RNA miktari 0.05 - 0.5 g/100mL arasindadir. Bulusun en çok tercih edilen uygulamasina göre, nütrisyon kompozisyonu D vitamini ile kombinasyon halinde en az bir nükleobaz kaynagi içermektedir. Diger yandan, RNA hafizayi ve zihinsel keskinligi güçlendirir, depresyonu tedavi eder ve enerjiyi arttirir. RNA ayni zamanda kemik kütlesini ve gücünü korumaya yardimci olur. Ayrica kanser geçiren hastalarda iyilesmeyi hizlandirir ve iyilesmeye yardimci olur. RNA gibi D vitamini de vücutta birçok role sahiptir. D vitamini kemiklerin saglikli olmasina, depresyonun tedavi edilmesine, bagisiklik ve sinir sistemi ile beyin sagliginin desteklenmesine yardimci olur ve kanserin gelisiminde rol oynayan genlerin ekspresyonunu etkiler. D vitamini ayni zamanda kandaki kalsiyum düzeylerinin düzenlenmesinde ve fosfor seviyelerinin korunmasinda da önemli role sahiptir. Bu faktörler kemiklerin saglikli kalmasi için hayati öneme sahiptir. D vitamini eksikligi kanser hastalarinda kendisini kemiklerin sertligini kaybetmesi ile göstermektedir. D vitamini eksikligi sonucunda kemik dansitesi azalmakta ve kaslar zayiflamaktadir. Ayrica, D vitamini eksikligi depresyon ve muhtemelen diger akil hastaliklarinda da rol oynamaktadir. Arastirmalara göre, D vitamini özellikle kanser olmak üzere birçok saglik sonucunu iyilestirebilir. Bu bilgiler isiginda, bagisiklik ve sinir sistemi ile beyin ve kemik sagliginin desteklenmesi açisindan etkinin arttirilmasi amaciyla ribonükleik asit özellikle D vitamini ile kombinasyon halinde kullanilmaktadir. Bu kombinasyonun, bu bilesenlerin hastanin sindirim sistemindeki emilimini arttirdigi görülmüstür. Dolayisiyla bilesenlerin etkinliginde de bir artis beklenmektedir. bu iki bilesenin emiliminin daha da arttirilabildigi görülmüstür. Bir uygulamaya göre, bahsedilen karbonhidrat kaynagi sukroz, maltodekstrin, fruktoz, hidrolize misir nisastasi, kati misir surubu, yüksek fruktozlu misir surubu veya bunlarin karisimlarini içeren gruptan seçilmektedir. Tercihen, özellikle pre-diyabetli ve tip 2 diyabet gelisme olasiligi yüksek olan kanserli hastalarda insülin direncini düsürmek amaciyla kompozisyon glukoz içermemektedir. Pre- diyabet genellikle insülin direnci olan kisilerde veya pankreastaki beta hücrelerinin kandaki glukoz düzeyini normal aralikta tutmaya yetecek kadar insülin üretmedigi kisilerde görülmektedir. Glukoz dogrudan ince bagirsakta emilerek kana karisir ve buradan da hücrelere giderek kan sekerini diger sekerlere kiyasla daha hizli arttirarak insülin salimini tetikler. Bu nedenle glukoz alimi pre-diyabet riskini önemli ölçüde arttirmaktadir. Ek olarak, çalismalarda laktoz malabsorpsiyonu prevalansinin kanserli hastalarda önemli ölçüde arttigi gösterildiginden, tercih edilen bir uygulamada kompozisyon hasta uyumunu arttirmak amaciyla laktoz içermemektedir.Tercih edilen bir uygulamada, kompozisyon maltodekstrin ve sukroz içermektedir.Spesifik olarak bu araliklar kullanildiginda sasirtici olarak kompozisyonun ozmolalitesinin düsürülebildigi görülmüstür. mOsm/L araligindadir. Bir uygulamaya göre, bahsedilen protein kaynagi kazein, soya, pirinç, bezelye, keçi boynuzu, yulaf, peynir alti suyu, kazeino-gliko-makropeptidler veya bunlarin karisimlarini içeren gruptan seçilmektedir. Tercihen, kompozisyon dengeli bir kati içerigi saglamak, isiya karsi iyi bir stabilite elde etmek ve tübüler sistemlerin kullanildigi bir üretim tesisinde akiciligi saglamak amaciyla peynir alti suyu içermemektedir. Tercih edilen uygulamaya göre, kompozisyon protein kaynagi olarak sodyum kazeinat ve kalsiyum kazeinat içermektedir. Sodyum kazeinatin kalsiyum kazeinata orani agirlikça 1:0.1 ile 1:10, tercihen 1:2 ile 1:5 arasindadir. Özellikle bu oranlar kullanildiginda zaman içerisinde sedimentasyon azalarak yüksek stabilite saglanmakta ve dolayisiyla raf ömrü artmaktadir.Protein kaynagi olarak sodyum kazeinat ve kalsiyum kazeinat kullaniminin ozmolalite düsüsünü destekledigi de görülmüstür. En çok tercih edilen bahsedilen oranin 1:4 olmasidir. Bir uygulamaya göre, bahsedilen yag kaynagi balik yagi, orta zincirli trigliseritler, kanola yagi, ayçiçegi yagi, yüksek oleikli ayçiçegi yagi, aspir yagi, soya yagi, zeytinyagi, misir yagi, yerfistigi yagi, pirinç kepegi yagi, tereyagi, findik yagi, yapilandirilmis lipidler veya bunlarin karisimlarini içeren gruptan seçilmektedir. Tercih edilen uygulamaya göre, bahsedilen yag kaynagi balik yagi, orta zincirli trigliseritler, kanola yagi, ayçiçegi yagi, yüksek oleikli ayçiçegi yagi veya bunlarin karisimlari içerisinden seçilmektedir. Yag kaynaginin bunlar içerisinden seçilmesiyle kompozisyonun raf ömrünün uzadigi ve oksidasyonun azaldigi gösterilmistir. Tercih edilen bir uygulamaya göre, kompozisyon ayrica dokosahekzaenoik asit (DHA) ve eikosapentaenoik asit (EPA) içermektedir. En fazla tercih edilen, balik tadinin ve kokusunun ortadan kaldirilmasi için kompozisyon içerisinde DHA ve EPA'nin kapsüllenmis formda bulunmasidir. Ek olarak, kapsülleme sonucunda üretim prosesi ve raf ömrü boyunca oksidasyon azalmaktadir. Oksidasyonun azalmasina katkida bulunmak amaciyla, arastirmalarda sasirtici sekilde bulunan belirli DHA ve EPA kombinasyon araliklari kullanilmaktadir. Bir uygulamaya göre, toplam yag miktarinin dokosahekzaenoik asit ve eikosapentaenoik asit kombinasyonunun Bir uygulamaya göre, bahsedilen lif kaynagi fruktooligosakkaridler, inülin, guar zamki, ksantan zamki, ksilo-oligosakkaridler, arap zamki, pektin, akasya zamki, dirençli nisasta, dekstranlar veya bunlarin karisimlarini içeren gruptan seçilmektedir. Tercih edilen uygulamaya göre kompozisyon, fruktooligosakkarid ve inülin içermektedir. g/100mL arasindadir. Spesifik olarak suda çözünen bu liflerin ve önceki teknige kiyasla nispeten yüksek olan bu miktarlarin seçilmesiyle, kanserli hastalarin bagirsak fonksiyonlarinin iyilestirilmesi hedeflenmektedir. Bir uygulamaya göre, nütrisyon kompozisyonu A vitamini, B1 vitamini (tiyamin), 82 vitamini (riboflavin), B3 vitamini (niyasin veya niyasinamid), BS vitamini (pantotenik asit), BG vitamini (piridoksin, piridoksal veya piridoksamin veya piridoksin hidroklorür), B7 vitamini (biyotin), BQ vitamini (folik asit), B12 vitamini (çesitli kobalaminler: genellikle vitamin takviyelerindeki siyanokobalamin), C vitamini, D vitamini, E vitamini, K vitamini, K1 ve K2 (MK-4, MK-7) vitaminleri, folik asit, biyotin, kolin veya bunlarin kombinasyonlarini içeren gruptan seçilen vitaminler içermektedir. Bir uygulamaya göre, nütrisyon kompozisyonu sodyum, potasyum, fosfor, magnezyum, klorür, demir, çinko, manganez, florür, bakir, iyot, selenyum, krom, bor, molibden, nikel, kalay, vanadyum, çinko veya bunlarin kombinasyonlarini içeren gruptan seçilen mineraller içermektedir. Bir uygulamaya göre, nütrisyon kompozisyonu oral yoldan veya besleme tüpü ile uygulanabilir. Bir uygulamaya göre, kompozisyonun enerji degeri, kanserli hastalarda günlük enerji ihtiyacini karsilamak amaciyla 140-170 kcal/100 mL araligindadir.Bulusun bir uygulamasina göre, kompozisyon asagidakileri içermektedir: - 8-12 g/100mL protein - 10-20 g/100mL karbonhidrat - 3-6 g/100mL yag -1-3 g/100mL Iif - 100-300 mg/100mL ribonükleik asit Bulusun tercih edilen bir uygulamasina göre, kompozisyon ayrica asagidakileri içermektedir: - 40-100 mg/100mL koIin - 50-150 mcg/100mL palmitat - 50-100 mcg/100mL beta karoten - 3-90 mcg/100mL D vitamini - 1-6 mcg/100mL E vitamini - 10-30 mcg/100mL K vitamini - 20-40 mg/100mL C vitamini - 40-100 mcg/100mL folik asit - 2-5 mg/100mL B3 vitamini - 0.5-5 mg/100mL BS vitamini - 3-10 mcg/100mL B7 vitamini - 50-300 mg/100mL sodyum - 100-400 mg/100mL potasyum - 40-100 mg/100mL klorür - 100-500 mg/100mL kalsiyum - 50-200 mg/100mL fosfor - 10-50 mg/100mL magnezyum -1-5 mg/100mL demir -1-5 mg/100mL çinko - 0.1-1 mg/100mL manganez - 100-500 mcg/100mL bakir - 10-50 mcg/100mL iyot - 5-20 mcg/100mL selenyum Analitik olarak seçilmis bu oranlar eksiksiz beslenme, toksik güvenlilik ve hasta uyumu için gerekli etkili dozlari saglamaktadir. Ayrica, bu oranlar stabiliteyi arttirmakta ve raf ömrünü uzatmaktadir. Tüm bu uygulamalara göre, asagida belirtilen formülasyonlar, bulusun konusu olan sivi kompozisyonda kullanilabilir. Örnek 1: Kemoterapi velveya radyoterapi alan velveya cerrahi öncesi ve sonrasi kanserli hastalara besin destegi saglayan sivi kompozisyon Içerik maddeleri Miktar protein 8-12 g/100mL karbonhidrat 10-20 g/100mL yag 3-6 g/100mL dokosahekzaenoik asit ve eikosapentaenoik asit lif 1-3 g/100mL 100-300 mg/100 mL ribonükleik asit 40-100 mg/100mL palmitat 50-150 mcg/100mL beta karoten 50-100 mcg/100mL D vitamini 3-90 mcg/100mL E vitamini 1-6 mcg/100mL K1 vitamini 10-30 mcg/100mL C vitamini 20-40 mg/100mL folik asit 40-100 mcg/100mL B1 vitamini 0.1-0.5 mg/100mL 82 vitamini 0.1-0.5 mg/100mL BG vitamini 0.1-0.5 mg/100mL B12 vitamini 0.3-1 mcg/100mL B3 vitamini 2-5 mg/100mL BS vitamini 0.5-5 mg/100mL B7 vitamini 3-10 mcg/100mL sodyum 50-300 mg/100mL potasyum 100-400 mg/100mL klorür 40-100 mg/100mL kalsiyum 100-500 mg/100mL fosfor 50-200 mg/ 100mL magnezyum 10-50 mg/100mL demir 1-5 mg/100mL çinko 1-5 mg/100mL manganez 0.1-1 mg/100mL bakir 100-500 mcg/100mL iyot 10-50 mcg/100mL selenyum 5-20 mcg/100mL krom 5-20 mcg/100mL moIibden 10-30 mcg/100mL Örnek 2: Kemoterapi velveya radyoterapi alan velveya cerrahi öncesi ve sonrasi kanserli hastalara besin destegi saglayan sivi kompozisyon Içerik maddeleri Miktar protein 10.6 g/100mL karbonhidrat 18.4 g/100mL yag 5.0 g/100mL dokosahekzaenoik asit ve 0.7 g/100mL eikosapentaenoik asit lif 2.1 g/100mL ribonükleik asit 0.18 g/100mL 51 mg/100mL palmitat 130 mcg/100mL beta karoten 70 mcg/100mL D vitamini 3.5 mcg/100mL E vitamini 2.57 mcg/100mL K vitamini 22 mcg/100mL C vitamini 35.2 mg/100mL folik asit 80 mcg/100mL B1 vitamini 0.31 mg/100mL B2 vitamini 0.41 mg/100mL BG vitamini 0.37 mg/100mL B12 vitamini 0.95 mcg/100mL B3 vitamini 3.75 mg/100mL B5 vitamini 1.6 mg/100mL B7 vitamini 9.3 mcg/100mL sodyum 60 mg/100mL potasyum 129 mg/100mL klorür 50 mg/100mL kalsiyum 204 mg/100mL fosfor 105 mg/100mL magnezyum 40 mg/100mL demir 1.8 mg/100mL çinko 2.4 mg/100mL manganez 0.4 mg/100mL bakir 270 mcg/100mL iyot 25 mcg/100mL selenyum 12.5 mcg/100mL krom 14.2 mcg/100mL moIibden 22.5 mcg/100mL Örnek 1 ve 2'de verilen yukarida sözü edilen sivi kompozisyonlar asagidaki adimlar takip edilerek hazirlanmaktadir: a. Suda çözünen bilesenlerin su içerisine karistirilmasi b. Karisimin pastörize edilmesi c. Karisima yag kaynaklarinin eklenmesi d. Tüm karisimin UHT islemine tabi tutulmasi TR TR Description NUTRITIONAL COMPOSITIONS FOR PATIENTS WITH CANCER BEFORE AND AFTER CHEMOTHERAPY VENEYA RADIOTHERAPY VEIVEYA SURGERY Technical Field The present invention relates to liquid compositions that provide nutritional support to patients receiving chemotherapy and/or radiotherapy and/or cancer before and after surgery. State of the Art Today, cancer causes deaths all over the world. It is one of the leading causes and the number of new cases is increasing rapidly in both developed and developing countries. Cancer is the second leading cause of death worldwide. According to the World Health Organization (WHO), 18.1 million new cancer cases were seen worldwide in 2018 and 9.6 million people died of cancer. However, thanks to advances in early diagnosis and medical treatments, the number of cancer survivors has increased significantly. However, most cancer patients experience malnutrition and high weight loss due to decreased food intake, emotional stress, and tumor-related metabolic changes. Nutritional status is an important determinant of successful treatment and quality of life (QoL) in patients with cancer. Adverse events resulting from cancer treatment also contribute to malnutrition and delays in cancer treatments, and may also contribute to death from cancer in a large proportion of patients. In many patients, the effects of cancer and cancer treatments also make eating difficult. Cancer treatments that affect nutrition include stem cell transplantation, chemotherapy, hormone therapy, radiation therapy, surgery and immunotherapy. When the head, neck, esophagus, stomach, intestines, pancreas or liver are affected by cancer treatment, it becomes difficult to get the nutrients necessary to stay healthy. Nutrition is the process by which food is ingested and used by the body for growth, health, and tissue regeneration. Good nutrition is important for health. Eating the right types of foods before, during and after cancer treatment can help a patient feel better and stay stronger. Additionally, cancer and cancer treatments can affect taste, smell, and appetite, as well as the ability to take in adequate amounts of food or absorb nutrients from meals. As a result, malnutrition, a disease caused by a lack of important nutrients, may occur. Malnutrition can cause a patient to become weak and tired, unable to fight infection or complete cancer treatment. Malnutrition can get worse when cancer progresses or spreads. It is important to get the right amount of protein and daily calorie needs to heal, fight infection, and have enough energy. The body needs protein to grow, repair tissues, and keep the immune system healthy. Cancer patients, in particular, often need more protein than normal. After surgery, chemotherapy or radiation therapy, the need for extra protein often arises to repair tissues and help fight infection. When the body does not get enough protein, it can cause muscle breakdown to obtain the energy it needs. . As a result, the disease will take longer to heal and infection resistance may decrease. On the other hand, many high protein liquid or semi-liquid nutritional compositions are available on the market. Nutritional compositions ensure that the body receives the nutrients it needs. These nutrients include proteins, fats, carbohydrates, water, vitamins and minerals. However, in the state of the art, there is no nutritional composition specifically containing RNA in addition to these components in catalyzing biochemical reactions in cancer patients, responding to cellular signals, regulating gene expression, synthesizing proteins and helping cells grow rapidly. In the patent literature, there are nutritional compositions specifically formulated for different age ranges and different purposes. These compositions can be used as supplements for malnutrition or as a complete nutritional source. For example, in the patent numbered EP0756827B1, a nutritional composition containing proteins and/or protein hydrolysates, carbohydrates, lipids, bulking agents and water is disclosed, especially for patients with impaired immune functions or tumors. Nutritional compositions in the state of the art contain protein, fat, carbohydrate, water, vitamins, minerals and ribonucleic acid. However, these compositions are not compositions that contain the nutrients needed by cancer patients in the required proportions. Considering the known state of the technique, it is specially prepared for patients receiving chemotherapy and/or radiotherapy and/or cancer before and after surgery, and will help keep the body healthy, repair damaged tissues, catalyze biochemical reactions, synthesize proteins and rapid proliferation of cells, and will also help to keep the body healthy. There is a need for nutritional compositions that provide complete and balanced nutrition, increasing stability by simultaneously reducing sedimentation and oxidation. During periods of illness, treatment or recovery, daily calorie and protein needs may be higher than normal. In light of the present invention or through the application of the present invention, other advantages or solutions to different problems may also emerge. Purposes and Brief Description of the Invention The present invention relates to liquid compositions that provide nutritional support to patients receiving chemotherapy and/or radiotherapy and/or cancer before and after surgery. It is an object of the present invention to obtain nutritional compositions that increase stability by simultaneously reducing sedimentation and oxidation. Another aim of the present invention is to obtain nutritional compositions in which osmolarity and osmolality are reduced, thus increasing patient compliance. Another aim of the present invention is to obtain glucose-free nutritional compositions with a balanced carbohydrate content to meet the daily energy needs of the patient. Another aim of the present invention is to obtain nutritional compositions containing biocompatible components without excess or competitive absorption. Another object of the present invention is to obtain nutritional compositions comprising essentially water, at least one protein source, at least one carbohydrate source, at least one fat source, at least one fiber source, vitamins and minerals. Another object of the present invention is to obtain nutritional compositions containing a source of nucleobases to catalyze biochemical reactions, respond to cellular signals, regulate gene expression, synthesize proteins and assist in the rapid proliferation of cells. Another object of the present invention is to obtain nutritional compositions containing a source of nucleobases, immune and nervous system, brain and providing nutritional compositions containing a nucleobase source in combination with vitamin D to support bone health. Another aim of the present invention is to obtain lactose-free nutritional compositions to protect the gastrointestinal system in cancer patients with sensitive stomach and intestines. Another aim of the present invention is to obtain nutritional compositions with high fiber content to support the gastrointestinal system. Another aim of the present invention is to obtain nutritional compositions containing caseinate in specific ranges as a protein source in order to provide low osmolarity and sedimentation. Another aim of the present invention is to obtain nutritional compositions containing docosahexaenoic acid and eicosapentaenoic acid in capsule form in order to reduce oxidation and eliminate odor. Another aim of the present invention is to develop a process for the preparation of such compositions in order to increase homogenization and reduce oxidation. Detailed Description of the Invention In accordance with the above-mentioned purposes, detailed features of the present invention are given herein. The present invention relates to liquid compositions that provide nutritional support to patients receiving chemotherapy and/or radiotherapy and/or cancer before and after surgery, the composition comprising: - at least one protein source selected from the group consisting of sodium caseinate and calcium caseinate or mixtures thereof, - at least one carbohydrate source, - at least one fat source, - at least one fiber source, - vitamins, - minerals, and the composition further comprises at least one nucleobase source in combination with vitamin D, the ratio of said nucleobase source to vitamin D being 1 by weight. :0.00007 In one embodiment, said nucleobase source is selected from the group consisting of ribonucleic acid (RNA) subunits, polymeric RNA forms, yeast RNA, or combinations thereof. According to the preferred embodiment, said nucleobase source is RNA. RNA is a chemical compound that can be produced by the body. RNA can also be produced in the laboratory. RNA is used as medicine or as a health supplement. RNA also has many functions in multicellular organisms, such as catalyzing biochemical reactions, responding to cellular signals, regulating gene expression, synthesizing proteins, and helping cells proliferate rapidly. In addition, RNA improves the immune response in the early postoperative period and helps to recover more quickly the weakened immune system after surgical trauma, chemotherapy and radiotherapy. Multicellular organisms also synthesize proteins with RNA. The main importance of RNA taken as a supplement for health is related to its ability to help cells multiply rapidly. This feature of RNA is very useful, especially in cases of surgery, chemotherapy, radiotherapy, injury and attacks on the immune system. For all these reasons, RNA supplementation is of great importance in patients receiving chemotherapy and/or radiotherapy and/or cancer before and after surgery. According to the most preferred embodiment of the invention, the amount of RNA present as a nucleobase source in the composition is between 0.05 - 0.5 g/100mL. According to the most preferred embodiment of the invention, the nutritional composition contains at least one nucleobase source in combination with vitamin D. On the other hand, RNA strengthens memory and mental acuity, treats depression and increases energy. RNA also helps maintain bone mass and strength. It also accelerates recovery and helps recovery in patients with cancer. Like RNA, vitamin D has many roles in the body. Vitamin D helps keep bones healthy, treats depression, supports immune and nervous system and brain health, and affects the expression of genes that play a role in the development of cancer. Vitamin D also plays an important role in regulating blood calcium levels and maintaining phosphorus levels. These factors are vital for keeping bones healthy. Vitamin D deficiency manifests itself in cancer patients as the bones lose their hardness. As a result of vitamin D deficiency, bone density decreases and muscles weaken. Additionally, vitamin D deficiency plays a role in depression and possibly other mental illnesses. According to research, vitamin D may improve many health outcomes, especially cancer. In the light of this information, ribonucleic acid is used especially in combination with vitamin D in order to increase the effect in supporting the immune and nervous system, as well as brain and bone health. This combination has been shown to increase the absorption of these ingredients in the patient's digestive tract. Therefore, an increase in the effectiveness of the components is expected. It has been observed that the absorption of these two components can be further increased. According to one embodiment, said carbohydrate source is selected from the group consisting of sucrose, maltodextrin, fructose, hydrolyzed corn starch, solid corn syrup, high fructose corn syrup, or mixtures thereof. Preferably, the composition does not contain glucose in order to reduce insulin resistance, especially in cancer patients with pre-diabetes and with a high probability of developing type 2 diabetes. Pre-diabetes usually occurs in people with insulin resistance or in people whose beta cells in the pancreas do not produce enough insulin to keep blood glucose levels within the normal range. Glucose is absorbed directly in the small intestine and mixes with the blood, where it goes to the cells and triggers insulin release by increasing blood sugar faster than other sugars. Therefore, glucose intake significantly increases the risk of pre-diabetes. Additionally, in a preferred embodiment, the composition does not contain lactose to increase patient compliance, as studies have shown that the prevalence of lactose malabsorption is significantly increased in patients with cancer. In a preferred embodiment, the composition contains maltodextrin and sucrose. Surprisingly, it has been observed that the osmolality of the composition can be reduced when these ranges are used specifically. It is in the range of mOsm/L. According to one embodiment, said protein source is selected from the group consisting of casein, soy, rice, pea, carob, oats, whey, caseino-glyco-macropeptides or mixtures thereof. Preferably, the composition does not contain whey in order to provide a balanced solids content, good stability to heat and to ensure fluidity in a production facility using tubular systems. According to the preferred embodiment, the composition contains sodium caseinate and calcium caseinate as protein sources. The ratio of sodium caseinate to calcium caseinate by weight is between 1:0.1 and 1:10, preferably between 1:2 and 1:5. Especially when these ratios are used, sedimentation decreases over time, ensuring high stability and therefore increasing the shelf life. It has also been observed that the use of sodium caseinate and calcium caseinate as protein sources supports the decrease in osmolality. The most preferred ratio is 1:4. According to one embodiment, said fat source is fish oil, medium chain triglycerides, canola oil, sunflower oil, high-oleic sunflower oil, safflower oil, soybean oil, olive oil, corn oil, peanut oil, rice bran oil, butter, hazelnut oil, structured lipids. or mixtures thereof. According to the preferred embodiment, said fat source is selected from fish oil, medium chain triglycerides, canola oil, sunflower oil, high-oleic sunflower oil or mixtures thereof. It has been shown that by choosing the oil source among these, the shelf life of the composition is extended and oxidation is reduced. According to a preferred embodiment, the composition further contains docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). The most preferred is the presence of DHA and EPA in encapsulated form in the composition to eliminate fishy taste and odor. Additionally, as a result of encapsulation, oxidation is reduced throughout the production process and shelf life. Certain ranges of DHA and EPA combinations are used, which have been surprisingly found in research to contribute to the reduction of oxidation. According to one embodiment, the total fat amount is determined by the combination of docosahexaenoic acid and eicosapentaenoic acid. According to one embodiment, said fiber source contains fructooligosaccharides, inulin, guar gum, xanthan gum, xylo-oligosaccharides, gum arabic, pectin, acacia gum, resistant starch, dextrans or mixtures thereof. is selected from the group. According to the preferred embodiment, the composition contains fructooligosaccharide and inulin. It is between g/100mL. By specifically selecting these water-soluble fibers and these relatively high amounts compared to the prior art, it is aimed to improve the intestinal functions of cancer patients. According to one embodiment, the nutritional composition includes vitamin A, vitamin B1 (thiamine), vitamin 82 (riboflavin), vitamin B3 (niacin or niacinamide), vitamin BS (pantothenic acid), vitamin BG (pyridoxine, pyridoxal or pyridoxamine or pyridoxine hydrochloride), B7 vitamin (biotin), vitamin BQ (folic acid), vitamin B12 (various cobalamins: usually cyanocobalamin in vitamin supplements), vitamin C, vitamin D, vitamin E, vitamin K, vitamins K1 and K2 (MK-4, MK-7), It contains vitamins selected from the group containing folic acid, biotin, choline or combinations thereof. According to one embodiment, the nutritional composition is minerals selected from the group consisting of sodium, potassium, phosphorus, magnesium, chloride, iron, zinc, manganese, fluoride, copper, iodine, selenium, chromium, boron, molybdenum, nickel, tin, vanadium, zinc, or combinations thereof. Contains. According to one embodiment, the nutritional composition may be administered orally or via a feeding tube. According to one embodiment, the energy value of the composition is in the range of 140-170 kcal/100 mL in order to meet the daily energy need in cancer patients. According to an embodiment of the invention, the composition contains the following: - 8-12 g/100mL protein - 10-20 g/100mL carbohydrate - 3-6 g/100mL fat - 1-3 g/100mL Iif - 100-300 mg/100mL ribonucleic acid According to a preferred embodiment of the invention, the composition further contains: - 40-100 mg/100mL choline - 50-150 mcg/ 100mL palmitate - 50-100 mcg/100mL beta carotene - 3-90 mcg/100mL Vitamin D - 1-6 mcg/100mL Vitamin E - 10-30 mcg/100mL Vitamin K - 20-40 mg/100mL Vitamin C - 40- 100 mcg/100mL folic acid - 2-5 mg/100mL vitamin B3 - 0.5-5 mg/100mL vitamin BS - 3-10 mcg/100mL vitamin B7 - 50-300 mg/100mL sodium - 100-400 mg/100mL potassium - 40-100 mg/100mL chloride - 100-500 mg/100mL calcium - 50-200 mg/100mL phosphorus - 10-50 mg/100mL magnesium -1-5 mg/100mL iron -1-5 mg/100mL zinc - 0.1- 1 mg/100mL manganese - 100-500 mcg/100mL copper - 10-50 mcg/100mL iodine - 5-20 mcg/100mL selenium These analytically selected ratios provide the effective doses required for complete nutrition, toxic safety and patient compliance. Additionally, these ratios increase stability and extend shelf life. According to all these applications, the formulations mentioned below can be used in the liquid composition that is the subject of the invention. Example 1: Liquid composition that provides nutritional support to patients with cancer before and after chemotherapy or radiotherapy or surgery Ingredients Quantity protein 8-12 g/100mL carbohydrate 10-20 g/100mL fat 3-6 g/100mL docosahexaenoic acid and eicosapentaenoic acid fiber 1 -3 g/100mL 100-300 mg/100 mL ribonucleic acid 40-100 mg/100mL palmitate 50-150 mcg/100mL beta carotene 50-100 mcg/100mL Vitamin D 3-90 mcg/100mL Vitamin E 1-6 mcg/ 100mL Vitamin K1 10-30 mcg/100mL Vitamin C 20-40 mg/100mL folic acid 40-100 mcg/100mL Vitamin B1 0.1-0.5 mg/100mL Vitamin 82 0.1-0.5 mg/100mL Vitamin BG 0.1-0.5 mg/100mL B12 vitamin 0.3-1 mcg/100mL vitamin B3 2-5 mg/100mL vitamin BS 0.5-5 mg/100mL vitamin B7 3-10 mcg/100mL sodium 50-300 mg/100mL potassium 100-400 mg/100mL chloride 40-100 mg /100mL calcium 100-500 mg/100mL phosphorus 50-200 mg/ 100mL magnesium 10-50 mg/100mL iron 1-5 mg/100mL zinc 1-5 mg/100mL manganese 0.1-1 mg/100mL copper 100-500 mcg/ Ingredients Quantity protein 10.6 g/100mL carbohydrate 18.4 g/100mL fat 5.0 g/100mL docosahexaenoic acid and 0.7 g/100mL eicosapentaenoic acid fiber 2.1 g/100mL ribonucleic acid 0.18 g/100mL 51 mg/100mL palmitate 130 mcg/100mL L beta carotene 70 mcg/ 100mL Vitamin D 3.5 mcg/100mL Vitamin E 2.57 mcg/100mL Vitamin K 22 mcg/100mL Vitamin C 35.2 mg/100mL folic acid 80 mcg/100mL Vitamin B1 0.31 mg/100mL Vitamin B2 0.41 mg/100mL Vitamin BG 0.37 mg/100mL L B12 vitamin 0.95 mcg/100mL vitamin B3 3.75 mg/100mL vitamin B5 1.6 mg/100mL vitamin B7 9.3 mcg/100mL sodium 60 mg/100mL potassium 129 mg/100mL chloride 50 mg/100mL calcium 204 mg/100mL phosphorus 105 mg/100mL magnese yum 40 mg/100mL iron 1.8 mg/100mL zinc 2.4 mg/100mL manganese 0.4 mg/100mL copper 270 mcg/100mL iodine 25 mcg/100mL selenium 12.5 mcg/100mL chromium 14.2 mcg/100mL moIibdenum 22.5 mcg/10 0mL given in Examples 1 and 2 The above mentioned liquid compositions are prepared by following the following steps: a. Mixing water-soluble components into water b. Pasteurization of the mixture c. Adding oil sources to the mixture d. Subjecting the entire mixture to UHT treatment TR TR
Claims (19)
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| PCT/TR2021/050062 WO2021167562A1 (en) | 2020-02-21 | 2021-01-26 | Nutritional compositions for cancer patients undergoing chemotherapy and/or radiotherapy and/or pre-post surgery |
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