Donaldson S S, Wesley M N, Ghavimi F, Shils M E, Suskind R M, DeWys W D
Med Pediatr Oncol. 1982;10(2):129-39. doi: 10.1002/mpo.2950100203.
A prospective randomized clinical trial was undertaken to test the efficacy of total parenteral nutrition (TPN) among previously untreated children receiving abdominal/pelvic irradiation with or without adjuvant chemotherapy who were at risk for weight loss, malnutrition, and complications from treatment. Children were evaluated by weight/height determinations, anthropomorphic measurements, and laboratory studies. TPN was associated with an improved nutritional status during therapy as compared with control patients on ad libitum intake. However, when TPN was discontinued, weight declined and there were no differences among treated and control patients detected at three-month follow-up. Likewise there was no obvious effect from TPN on tolerance to therapy in the adequately nourished child. TPN as initial supportive therapy should be reserved for those children who are malnourished or marginally malnourished at the time of presentation. Close nutritional assessment during treatment is essential since approximately 25% of children undergoing abdominal/pelvic radiotherapy with chemotherapy can be expected to become malnourished during an initial course of therapy.
开展了一项前瞻性随机临床试验，以测试全胃肠外营养（TPN）在接受腹部/盆腔放疗且有或无辅助化疗的未接受过治疗的儿童中的疗效，这些儿童有体重减轻、营养不良及治疗并发症的风险。通过体重/身高测定、人体测量和实验室研究对儿童进行评估。与随意进食的对照患者相比，TPN在治疗期间与营养状况改善相关。然而，当停用TPN时，体重下降，在三个月的随访中未发现治疗组和对照组患者之间存在差异。同样，TPN对营养充足的儿童的治疗耐受性也没有明显影响。TPN作为初始支持治疗应保留给就诊时营养不良或轻度营养不良的儿童。治疗期间进行密切的营养评估至关重要，因为预计约25%接受腹部/盆腔放疗联合化疗的儿童在初始治疗过程中会出现营养不良。
