title: A prospective observational study assessing home parenteral nutrition in patients with gastrointestinal cancer: benefits for quality of life.
abstract: BACKGROUND
  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).
  
  
  OBJECTIVE
  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).
  
  
  CONCLUSIONS
  HPN could provide benefit for malnourished patients with gastrointestinal cancer. However, randomized controlled studies are required to confirm this benefit and the safety profile.
authors.affiliation: 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. Electronic address: pierre.senesse@icm.unicancer.fr.
authors.forename: Pierre
authors.initials: P
authors.lastname: Senesse
authors.affiliation: Scientific Department, ClinSearch, Bagneux, France.
authors.forename: Abir
authors.initials: A
authors.lastname: Tadmouri
authors.affiliation: Department of Oncology, Hospital Henri Mondor, Créteil, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Culine
authors.affiliation: Centre de Lutte Contre Cancer, Centre Paul Strauss, Strasbourg, France.
authors.forename: Patrick R
authors.initials: PR
authors.lastname: Dufour
authors.affiliation: Department of Oncology, Polyclinique de Blois, Blois, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Seys
authors.affiliation: Department of Oncology, Centre Frédéric Joliot, Rouen, France.
authors.forename: Abderraouf
authors.initials: A
authors.lastname: Radji
authors.affiliation: Department of Oncology, Radiation Oncology Centre, Bayonne, France.
authors.forename: Maciej
authors.initials: M
authors.lastname: Rotarski
authors.affiliation: Department of Hepatogastroenterology, Hospital Antoine Béclère, Clarmart, France.
authors.forename: Axel
authors.initials: A
authors.lastname: Balian
authors.affiliation: Clinical Nutrition Intensive Care Unit, Hospices Civils de Lyon, Lyon, France.
authors.forename: Cecile
authors.initials: C
authors.lastname: Chambrier
mesh_terms: D000368:Aged; D001835:Body Weight; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000178:diet therapy* / Q000503:physiopathology* / Q000523:psychology; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000178:diet therapy* / Q000503:physiopathology* / Q000523:psychology; D008875:Middle Aged; D009752:Nutritional Status; D016331:Parenteral Nutrition, Home; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Gastrointestinal cancer; home parenteral nutrition; quality of life; undernutrition