Home parenteral nutrition (HPN) in incurable cancer patients: patients’ qualification criteria and treatment outcome

Abstract

Aim. Parenteral nutrition (PN) represents a recognized therapeutic modality for intestinal failure patients, independently
of its etiology. Home parenteral nutrition (HPN) has, however, become controversial in oncological patients,
and creation of widely accepted indications for this treatment has become difficult. The aim of the study was to
assess treatment outcome in cancer HPN patients as well as to propose recommendations for this kind of treatment
in advanced cancer patients.

Material and methods. 69 patients (42 F, 27 M, mean age 58.1 y.) treated between January 2009 and June 2012 were
analyzed. The study group was formed of gastric, pancreatic, colon, esophagus, gall bladder, ovarian and uterus cancer
patients. The time of treatment and quality of life of the patients were analyzed.

Results. The mean overall survival time reached 99.8 days but varied among tumour groups. It was longer in ovarian and uterine cancer than in any other neoplasm (231.8 vs. 99.8 days, p < 0.05). The quality of life was also higher in the ovarian and uterine cancer group (7.8 vs. 4.3 points, p < 0.05) , while it was significantly lower in the others.

Conclusions. Home parenteral nutrition should be considered as a therapeutic option in every patient with advanced ovarian and uterine cancer. In other advanced cancer patients its use should be carefully considered as its value is not so convincing.