Quality of life and length of survival in advanced cancer patients on home parenteral nutrition.
BACKGROUND
The use of home parenteral nutrition (HPN) in patients with advanced cancer is controversial because survival is usually short and there are no data regarding the quality of life (QoL).


METHODS
Sixty-nine advanced cancer patients enrolled in a program of HPN in six different Italian centers were prospectively studied as regards nutritional status (body weight, serum albumin, serum transferrin and total lymphocyte count), length of survival and QoL through the Rotterdam Symptom Checklist questionnaire. These variables were collected at the start of HPN and then at monthly intervals. All these patients were severely malnourished, almost aphagic and beyond any possibility of cure.


RESULTS
Nutritional indices maintained stable until death. Median survival was 4 months (range 1-14) and about one-third of patients survived more than 7 months. QoL parameters remained stable till 2-3 months before death.


CONCLUSIONS
HPN may benefit a limited percentage of patients who may survive longer than the time allowed by a condition of starvation and depletion. Provided that these patients survive longer than 3 months, there is some evidence that QoL remains stable for some months and acceptable for the patients.
Italian Society for Parenteral and Enteral Nutrition, Milan, Italy.
F
F
Bozzetti
Luca
L
Cozzaglio
E
E
Biganzoli
G
G
Chiavenna
M
M
De Cicco
D
D
Donati
G
G
Gilli
S
S
Percolla
L
L
Pironi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000401:mortality; D009748:Nutrition Disorders / Q000209:etiology / Q000628:therapy*; D009752:Nutritional Status; D016331:Parenteral Nutrition, Home; D018579:Patient Selection; D011446:Prospective Studies; D011788:Quality of Life; D016019:Survival Analysis; D019452:Terminally Ill