Abstract:
CONTEXT: Patients with gastrointestinal cancer are at high risk for deterioration of nutrition. Home parenteral nutrition could improve nutritional status and quality of life.
OBJECTIVES: The purpose of this study was 1) to evaluate the impact of home parenteral nutrition on quality of life, 2) to assess changes in nutritional status, and 3) to assess proxy perception of patient well-being.
METHODS: We conducted a prospective, observational, multicenter study. Inclusion criteria were adult patients with gastrointestinal cancer, for whom home parenteral nutrition was indicated and prescribed for at least 14 days. The physician, the patient and a family member completed questionnaires at inclusion and 28 days later. Quality of life was assessed by the patients using the Functional Assessment of Cancer Therapy-General questionnaire, at inclusion and 28 days later.
RESULTS: The study included 370 patients with gastrointestinal cancer. Home parenteral nutrition was indicated for cancer-related undernutrition in 89% of patients, and was used as a complement to oral intake in 84%. After 28 days of parenteral intake, global quality of life was significantly increased (48.9 at inclusion vs. 50.3, P=0.007). The patients’ weight improved significantly by 2.7% (P<0.001). The nutrition risk screening also decreased significantly (3.2 ± 1.1 vs. 2.8 ± 1.3, P=0.003).
CONCLUSION: Home parenteral nutrition could provide benefit for malnourished patients with gastrointestinal cancer. However, randomized controlled studies are required to confirm this benefit and the safety profile.
Reference:
Senesse, P., Tadmouri, A., Culine, S., Dufour, P.R., Seys, P., Radji, A., Rotarski, M., Balian, A. and Chambrier, C. (2014) A Prospective Observational Study Assessing Home Parenteral Nutrition in Patients With Gastrointestinal Cancer: Benefits for Quality of Life. Journal of Pain and Symptom Management. June 16th. (epub ahead of print).