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. 2021 Apr;29(4):1977-1988.
doi: 10.1007/s00520-020-05687-4. Epub 2020 Aug 22.

Supplemental home parenteral nutrition improved nutrition status with comparable quality of life in malnourished unresectable/metastatic gastric cancer receiving salvage chemotherapy

Cheng-Jen Ma  1   2 , Ching-Wen Huang  1   3 , Yung-Sung Yeh  1   4 , Hsiang-Lin Tsai  1   3 , Wei-Chih Su  1 , Tsung-Kun Chang  1 , Li-Chu Sun  5   6 , Ying-Ling Shih  5   6 , Fang-Jung Yu  7   8 , Deng-Chyang Wu  7   8 , Jaw-Yuan Wang  9   10   11   12   13   14   15
Affiliations

Supplemental home parenteral nutrition improved nutrition status with comparable quality of life in malnourished unresectable/metastatic gastric cancer receiving salvage chemotherapy

Cheng-Jen Ma et al. Support Care Cancer. 2021 Apr.

Abstract

Background: Even with significant advances in surgical techniques and treatment, salvage chemotherapy remains the major treatment strategy for patients with unresectable or metastatic gastric cancer (GC). Practical and technical advances have simplified safe and convenient use of supplemental home parenteral nutrition (HPN). We aimed to clarify the role of HPN in patients with incurable GC undergoing salvage chemotherapy.

Methods: We enrolled 25 patients with GC with a nutritional risk index (NRI) of ≦ 97.5 undergoing HPN. Their nutritional status, laboratory data, and quality of life (QoL) were analyzed using the Research and Treatment of Cancer quality of life questionnaire-C30 before and after HPN administration at 0.5, 1, 2, and 3 months. We enrolled 25 patients with an NRI of > 97.5 not undergoing HPN as the control group.

Results: Total protein (P = 0.008), prealbumin (P < 0.001), and total cholesterol (P = 0.023) levels improved significantly after 0.5 months of HPN administration. The study group also demonstrated a marked improvement in nitrogen balance (P = 0.004) and prealbumin levels (P < 0.012) after 1 month. Gains in body weight after 1 month and body mass index after 2 months of HPN administration remained comparable with those of the control group. Global QoL scores were maintained and comparable with those of the control group.

Conclusions: Supplemental HPN therapy for malnourished patients with unresectable or metastatic GC undergoing salvage chemotherapy is feasible and revealed marked improvement in nutritional status. Early HPN intervention should be considered an important part of palliative treatment for advanced GC.

Keywords: Gastric cancer; Home parenteral nutrition; Malnutrition; Palliative care.

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