Home parenteral nutrition improves quality of life and nutritional status in patients with cancer: a French observational multicentre study
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Malnutrition is a predictor of poor outcomes in patients with cancer. Little is known about the benefit of nutritional support in these patients. The purpose of this study was to assess the impact of home parenteral nutrition (HPN) on quality of life (Qol) in cancer patients.
We performed an observational prospective study to determine the impact of HPN on Qol in a population of patients with heterogeneous cancer. Physicians, patients and family members had to complete a questionnaire before HPN administration and 28 days after the course of HPN. Qol was evaluated using the self-administered questionnaire FACT-G.
We included 767 patients with cancer of whom 437 ended the study. Mean patient age was 63 ± 11.4 years and 60.5 % were men. Primary gastrointestinal cancer was reported in 50 % of patients and 65.3 % were presenting metastases. Malnutrition was reported in 98.3 %. After 28 days of HPN intake, significant improvement was observed in the Qol (49.95 ± 5.82 vs. 48.35 ± 5.01 at baseline, p < 0.0001). The mean weight, serum albumin and the nutrition risk index had also improved significantly. Most patients (78 %) had perceived a positive impact of the HPN. A significant improvement in patient’s well-being was perceived also by family members and physicians.
Our data suggest that preventing and correcting malnutrition using HPN in patients with cancer might have a significant benefit on their well-being. Randomized controlled studies are required to confirm this finding.
KeywordsCancer Malnutrition Home parenteral nutrition Quality of life Nutritional status
The authors would like to thank all of the study investigators at the sites participating in this trial: Dr. Sakka, Besançon; Dr. Rastgari, Créteil; Dr. Lababidi, Paris; Dr. Pacault, Paris; Dr. Botrus, Thionville; Dr. Bastit, Rouen; Dr. Guilbert, Reims; Dr. Coulon, Limoges; Dr. Hamlaoui, Besançon; Dr. Sedrati, Stains; Dr. Chuzel, Mougins; Dr. Narciso, Tours; Dr. Fabre-Guillevin, Paris; Dr. Crumbach, Freyming-Merlebach; Dr. Savinelli, Paris; Dr. Ferrier, Clermont-Ferrand; Dr. Perotin, Montpellier; Dr. Poisson-Ligeza, St Nazaire; Dr. Sellam, Créteil; Dr. Fadin, Reims; Dr. Dubroeucq, Reims; Dr. Wagner, Chambray Les Tours; Dr. Hadjadj, Marseille; Dr. Faure, Montpellier; Dr. Aldabbagh, Montpellier; Dr. Cretineau, Vandoeuvre Les Nancy; Dr. Bartholomot-Forgeot, St Nazaire; and Kalivie investigator group. The authors wish to thank Doctor Claude Yvon, Medical Affairs Director of Fresenius-Kabi, for her assistance in preparing this manuscript.
This work was supported by Fresenius-Kabi France.
Conflict of interest
All authors have declared no conflicts of interest. The authors have full control of all primary data and agree to allow the journal to review their data if requested.
- 7.Mitry E, Douillard JY, Van Cutsem E, Cunningham D, Magherini E, Mery-Mignard D, Awad L, Rougier P (2004) Predictive factors of survival in patients with advanced colorectal cancer: an individual data analysis of 602 patients included in irinotecan phase III trials. Ann Oncol Off J Eur Soc Med Oncol / ESMO 15(7):1013–1017. doi: 10.1093/annonc/mdh267 CrossRefGoogle Scholar
- 11.Davis MP, Dickerson D (2000) Cachexia and anorexia: cancer's covert killer. Support Care Cancer Off J Multinatl Assoc Support Care Cancer 8(3):180–187Google Scholar
- 19.Staun M, Pironi L, Bozzetti F, Baxter J, Forbes A, Joly F, Jeppesen P, Moreno J, Hebuterne X, Pertkiewicz M, Muhlebach S, Shenkin A, Van Gossum A (2009) ESPEN Guidelines on Parenteral Nutrition: Home Parenteral Nutrition (HPN) in adult patients. Clin Nutr 28(4):467–479. doi: 10.1016/j.clnu.2009.04.001 PubMedCrossRefGoogle Scholar
- 20.Chermesh I, Mashiach T, Amit A, Haim N, Papier I, Efergan R, Lachter J, Eliakim R (2011) Home parenteral nutrition (HTPN) for incurable patients with cancer with gastrointestinal obstruction: do the benefits outweigh the risks? Med Oncol 28(1):83–88. doi: 10.1007/s12032-010-9426-2 PubMedCrossRefGoogle Scholar
- 21.Hasenberg T, Essenbreis M, Herold A, Post S, Shang E (2010) Early supplementation of parenteral nutrition is capable of improving quality of life, chemotherapy-related toxicity and body composition in patients with advanced colorectal carcinoma undergoing palliative treatment: results from a prospective, randomized clinical trial. Color Dis Off J Assoc Coloproctology Great Brit Ireland 12(10 Online):e190–e199. doi: 10.1111/j.1463-1318.2009.02111.x CrossRefGoogle Scholar
- 22.Cozzaglio L, Balzola F, Cosentino F, DeCicco M, Fellagara P, Gaggiotti G, Gallitelli L, Giacosa A, Orban A, Fadda M, Gavazzi C, Pirovano F, Bozzetti F (1997) Outcome of cancer patients receiving home parenteral nutrition. Italian Society of Parenteral and Enteral Nutrition (S.I.N.P.E.). JPEN J Parenter Enter Nutr 21(6):339–342CrossRefGoogle Scholar
- 27.Trabal J, Leyes P, Forga MT, Hervas S (2006) Quality of life, dietary intake and nutritional status assessment in hospital admitted cancer patients. Nutricion hospitalaria: organo oficial de la Sociedad Espanola de Nutricion Parenteral y Enteral 21(4):505–510Google Scholar