title: Effect of adenosine 5'-triphosphate infusions on the nutritional status and survival of preterminal cancer patients.
abstract: The aim of the study was to investigate the effect of intravenous infusions of adenosine 5'-triphosphate (ATP) on nutritional status and survival in preterminal cancer patients. Ninety-nine preterminal cancer patients (estimated life expectancy 1-6 months) with mixed tumor types were randomly allocated to receive either intravenous ATP weekly (8-10 h/week, maximum 50 microg/kg/min) for 8 weeks, or no ATP (control group). Nutritional status parameters were assessed until 8 weeks, and analyzed by repeated-measures analysis of covariance. Cox proportional hazards models were fitted to assess the effect of ATP on short-term (0-8 weeks) and long-term (0-6 months) survival. Fifty-one patients were randomized to ATP and 48 to the control group. Results showed a significant favorable effect of ATP on triceps skin fold thickness [between-group difference per 8 weeks 1.76 mm, 95% confidence interval (CI): 0.48-3.12 mm; P = 0.009] and on short-term survival [0-8 weeks hazard ratio (HR): 0.40, 95% CI: 0.17-0.95; P = 0.037]. In weight-stable patients and in lung cancer patients, long-term survival (0-6 months) was also significantly better in ATP-treated patients (weight-stable patients HR: 0.40, 95% CI: 0.19-0.83; P = 0.014; patients with lung cancer: HR: 0.35, 95% CI: 0.14-0.88; P = 0.025). In conclusion, in this population of preterminal cancer patients, ATP infusions, at the dose and schedule studied, had a favorable effect on triceps skin fold thickness and survival, especially in weight-stable patients and patients with lung cancer. Larger studies are warranted to confirm these findings and to further define the effect of ATP on tumor growth and survival.
authors.affiliation: Department of Epidemiology, Maastricht University, Maastricht 6200 MD, The Netherlands. sandra.beijer@epid.unimaas.nl
authors.forename: Sandra
authors.initials: S
authors.lastname: Beijer
authors.forename: Pierre S
authors.initials: PS
authors.lastname: Hupperets
authors.forename: Ben E
authors.initials: BE
authors.lastname: van den Borne
authors.forename: Simone R
authors.initials: SR
authors.lastname: Eussen
authors.forename: Arjen M
authors.initials: AM
authors.lastname: van Henten
authors.forename: Marieke
authors.initials: M
authors.lastname: van den Beuken-van Everdingen
authors.forename: Alexander
authors.initials: A
authors.lastname: de Graeff
authors.forename: Ton A
authors.initials: TA
authors.lastname: Ambergen
authors.forename: Piet A
authors.initials: PA
authors.lastname: van den Brandt
authors.forename: Pieter C
authors.initials: PC
authors.lastname: Dagnelie
mesh_terms: D000255:Adenosine Triphosphate / Q000627:therapeutic use*; D000368:Aged; D000704:Analysis of Variance; D002100:Cachexia / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D009752:Nutritional Status / Q000187:drug effects*; D016016:Proportional Hazards Models; D012885:Skinfold Thickness; D015996:Survival Rate
chemical_list: D000255:Adenosine Triphosphate