Impact of home enteral nutrition in malnourished patients with upper gastrointestinal cancer: A multicentre randomised clinical trial. (September 2016)

• Record Type: Journal Article
• Authors: Gavazzi, Cecilia; Colatruglio, Silvia; Valoriani, Filippo; Mazzaferro, Vincenzo; Sabbatini, Annarita; Biffi, Roberto; Mariani, Luigi; Miceli, Rosalba
• Is Part Of: European journal of cancer. Volume 64(2016)
• Page Start: 107
• Page End: 112
• Publication Date: 2016-09
• Subjects: Gastrointestinal cancer -- Malnutrition -- Home enteral nutrition -- Nutritional counselling; Cancer -- Periodicals; Neoplasms -- Periodicals; Cancer -- Périodiques; Cancer; Tumors; Electronic journals; Periodicals; Electronic journals; 616.994
• DOI: 10.1016/j.ejca.2016.05.032
• Languages: English
• ISSNs: 0959-8049

Abstract

Abstract: Background: Weight loss is frequent in patients with gastrointestinal (GI) cancer. Nutritional status deteriorates throughout anti-cancer treatment, mostly after major surgery, increasing complications, reducing tolerance and worsening the final prognosis. Enteral nutrition is safe and effective in malnourished patients undergoing major GI surgery. Randomised trials aimed at investigating the effects of home enteral nutrition (HEN) in post-surgical patients with GI cancer are lacking. This study compares HEN and counselling in limiting weight loss during oncologic treatment. Patients and methods: Patients with upper GI cancer and candidate to major surgery were included in the protocol when the nutritional risk screening (NRS 2002) score was ≥3. All patients were supported with enteral nutrition through a jejunostomy after surgery and randomly assigned to continue enteral nutrition or receiving nutritional counselling after discharge. Nutritional and performance status, quality of life (QoL) and tolerance to cancer treatment have been evaluated at 2 and 6 months after discharge. Results: Seventy-nine patients were randomised; 38 continued enteral nutrition at home and 41 patients received nutritional counselling only. After 2 months, patients on HEN maintained their mean body weight, while patients in the nutritional counselling group showed a weight loss of 3.6 kg. Patients supported on HEN had a higher chance to complete chemotherapy as planned (48% versus 34%). QoL was not worsened by HEN. No complications were reported. Conclusions: HEN is a simple and feasible treatment to support malnourished patients with upper GI cancer after major surgery and during chemotherapy in order to limit further weight loss. Highlights: This study evaluated the impact of nutrition interventions to control weight loss in upper gastrointestinal cancer patients. Home enteral nutrition and nutritional counselling after major surgery are compared. The effects of nutrition interventions are evaluated for 6 months. Home enteral nutrition limited weight loss and increased the chance to complete chemotherapy.