title: Oral nutritional support can shorten the duration of parenteral hydration in end-of-life cancer patients: a randomized controlled trial.
abstract: Tube feeding or hydration is often considered for end-of-life cancer patients despite the negative effects on quality of life. The efficacy of oral nutritional support in this setting is unknown. We conducted a randomized trial to compare the efficacies of an amino acid jelly, Inner Power® (IP), and a liquid enteral product, Ensure Liquid® (EL), in terminally ill cancer patients. We randomly assigned patients to 3 arms: EL, IP, and EL+IP. The primary endpoint was drip infusion in vein (DIV)-free survival, which was defined as the duration from nutritional support initiation to administration of parenteral hydration. Twenty-seven patients were enrolled in the study, of whom 21 were included in the intention-to-treat analysis. The median age of the subjects was 69 yr. There were significant differences between the arms with regard to the median DIV-free survival (0.5, 6.0, and 4.5 days in the EL, IP, and EL + IP arms, respectively; P = 0.05). The median overall survival was 7, 9, and 8 days in the EL, IP, and EL + IP arms, respectively. IP may shorten the duration of parenteral hydration in terminally ill cancer patients and does not affect their survival.
authors.affiliation: a Department of Palliative Medicine, The Institute of Medical Science , The University of Tokyo , Tokyo , Japan.
authors.forename: Hiroto
authors.initials: H
authors.lastname: Ishiki
authors.forename: Satoru
authors.initials: S
authors.lastname: Iwase
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Gyoda
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kanai
authors.forename: Keisuke
authors.initials: K
authors.lastname: Ariyoshi
authors.forename: Tempei
authors.initials: T
authors.lastname: Miyaji
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Tahara
authors.forename: Takashi
authors.initials: T
authors.lastname: Kawaguchi
authors.forename: Mieko
authors.initials: M
authors.lastname: Chinzei
authors.forename: Takuhiro
authors.initials: T
authors.lastname: Yamaguchi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000596:Amino Acids / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003680:Deglutition Disorders / Q000209:etiology* / Q000503:physiopathology; D003681:Dehydration / Q000209:etiology / Q000517:prevention & control*; D019422:Dietary Sucrose; D004750:Enteral Nutrition / Q000009:adverse effects; D005260:Female; D005440:Fluid Therapy / Q000009:adverse effects; D005526:Food, Formulated; D006801:Humans; D007262:Infusions, Intravenous; D057194:Intention to Treat Analysis; D007564:Japan; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality / Q000503:physiopathology*; D011788:Quality of Life; D015532:Rehydration Solutions / Q000008:administration & dosage / Q000627:therapeutic use; D016019:Survival Analysis; D013727:Terminal Care; D013997:Time Factors
chemical_list: D000596:Amino Acids; D019422:Dietary Sucrose; D015532:Rehydration Solutions; C082131:Ensure formulated food