一项评估胃肠癌患者家庭肠外营养的前瞻性观察性研究：对生活质量的益处。

A prospective observational study assessing home parenteral nutrition in patients with gastrointestinal cancer: benefits for quality of life.

作者信息

Senesse Pierre, Tadmouri Abir, Culine Stéphane, Dufour Patrick R, Seys Patrick, Radji Abderraouf, Rotarski Maciej, Balian Axel, Chambrier Cecile

机构信息

SIRIC Montpellier Cancer, Institut régional du Cancer de Montpellier (ICM), Montpellier, France; Laboratory Epsylon, EA 4556 Dynamics of Human Abilities & Health Behaviors, University of Montpellier, Montpellier, France; Department of Clinical Nutrition and Gastroenterology, ICM, Montpellier, France.

Scientific Department, ClinSearch, Bagneux, France.

出版信息

J Pain Symptom Manage. 2015 Feb;49(2):183-191.e2. doi: 10.1016/j.jpainsymman.2014.05.016. Epub 2014 Jun 16.

DOI:10.1016/j.jpainsymman.2014.05.016

PMID:24945492

Abstract

CONTEXT

Patients with gastrointestinal cancer are at high risk for deterioration of nutrition. Home parenteral nutrition (HPN) could improve nutritional status and quality of life (QoL).

OBJECTIVES

The purpose of this study was 1) to evaluate the impact of HPN on QoL, 2) to assess changes in nutritional status, and 3) to assess proxy perception of patient well-being.

METHODS

We conducted a prospective, observational, and a multicenter study. Inclusion criteria were adult patients with gastrointestinal cancer, for whom HPN 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. The QoL 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. The HPN was indicated for cancer-related undernutrition in 89% of the patients and was used as a complement to oral intake in 84%. After 28 days of parenteral intake, global QoL 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

HPN could provide benefit for malnourished patients with gastrointestinal cancer. However, randomized controlled studies are required to confirm this benefit and the safety profile.

摘要

背景

胃肠道癌患者存在营养状况恶化的高风险。家庭肠内营养（HPN）可改善营养状况和生活质量（QoL）。

目的

本研究的目的是1）评估HPN对QoL的影响，2）评估营养状况的变化，以及3）评估对患者幸福感的代理感知。

方法

我们进行了一项前瞻性、观察性多中心研究。纳入标准为胃肠道癌成年患者，其被指征并开具HPN处方至少14天。医生、患者及一名家庭成员在纳入时和28天后完成问卷。患者在纳入时和28天后使用癌症治疗功能评估通用问卷评估QoL。

结果

该研究纳入370例胃肠道癌患者。89%的患者HPN用于癌症相关营养不良，84%用作口服摄入的补充。肠内摄入28天后，总体QoL显著提高（纳入时为48.9，vs. 50.3，P = 0.007）。患者体重显著改善2.7%（P < 0.001）。营养风险筛查也显著降低（3.2±1.1 vs. 2.8±1.3，P = 0.003）。