Effects of current parenteral nutrition treatment on health-related quality of life, physical function, nutritional status, survival and adverse events exclusively in patients with advanced cancer: A systematic literature review

Randi Tobberup; Lene Thoresen; Ursula G Falkmer; Mette K Yilmaz; Tora S Solheim; Trude R Balstad

doi:10.1016/j.critrevonc.2019.04.014

Effects of current parenteral nutrition treatment on health-related quality of life, physical function, nutritional status, survival and adverse events exclusively in patients with advanced cancer: A systematic literature review

Crit Rev Oncol Hematol. 2019 Jul:139:96-107. doi: 10.1016/j.critrevonc.2019.04.014. Epub 2019 Apr 20.

Authors

Randi Tobberup¹, Lene Thoresen², Ursula G Falkmer³, Mette K Yilmaz⁴, Tora S Solheim⁵, Trude R Balstad⁵

Affiliations

¹ Center for Nutrition and Bowel Disease, Department of Gastroenterology, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Fredrik Bajers Vej 5, 9100, Aalborg, Denmark. Electronic address: r.tobberup@rn.dk.
² Cancer Clinic, St. Olavs hospital, Trondheim University hospital, Postboks 3250 Torgarden, NO-7006, Trondheim, Norway; National Advisory Unit on Disease-Related Malnutrition, Oslo University Hospital, Sognsvannsveien 9, 0372, Oslo, Norway.
³ Department of Clinical Medicine, Aalborg University, Fredrik Bajers Vej 5, 9100, Aalborg, Denmark; Department of Oncology, Clinical Cancer Research Center, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark.
⁴ Department of Oncology, Clinical Cancer Research Center, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark.
⁵ Cancer Clinic, St. Olavs hospital, Trondheim University hospital, Postboks 3250 Torgarden, NO-7006, Trondheim, Norway; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology, PO Box 8905, NO-7491, Trondheim, Norway.

PMID: 31150954
DOI: 10.1016/j.critrevonc.2019.04.014

Abstract

Background: The aim was to evaluate the effects of current parenteral nutrition (PN) treatment on clinical outcomes in patients with advanced cancer.

Methods: This review was conducted according to the PRISMA guidelines (PROSPERO ID: 4201707915).

Results: Two underpowered randomized controlled trials and six observational studies were retrieved (n = 894 patients). Health-related quality of life and physical function may improve during anti-neoplastic treatment in who PN treatment is the only feeding opportunity, but not necessarily in patients able to feed enterally. Nutritional status may improve in patients regardless of anti-neoplastic treatment and gastrointestinal function. PN treatment was neither superior to fluid in terminal patients nor to dietary counselling in patients able to feed enterally in regards to survival. The total incidence of adverse events was low.

Conclusion: Current PN treatment in patients with advanced cancer is understudied and the level of evidence is weak.

Keywords: Cachexia; Intravenous nutrition; Palliative care; Performance status; Supportive care; Weight loss.

Publication types

Systematic Review

MeSH terms

Activities of Daily Living*
Humans
Neoplasms / complications
Neoplasms / diet therapy
Neoplasms / mortality*
Nutrition Disorders / etiology
Nutrition Disorders / prevention & control*
Nutritional Status*
Nutritional Support
Parenteral Nutrition / adverse effects
Parenteral Nutrition / methods*
Prognosis
Quality of Life*