BACKGROUND: In cancer patients, weight loss is an ominous sign suggesting disease progression and shortened survival time. As a result, providing nutrition support for cancer patients has been proposed as a logical approach for improving clinical outcomes. Nutrition support can be given to patients through enteral nutrition (EN) or parenteral nutrition (PN). The purpose of the review was to compare the outcomes of PN and EN in cancer patients. METHODS: A literature search was conducted in Ovid MEDLINE and OLDMEDLINE, Embase Classic and Embase, and Cochrane Central Register of Controlled Trials. Studies were included if over half of the patient population had cancer and reported on any of the following endpoints: the percentage of patients that experienced no infection, nutrition support complications, major complications or mortality. Risk ratios (RR) and 95% confidence intervals (CIs) using Review Manager Version 5.3 were calculated. Primary endpoints were stratified according to type of EN for subgroup analysis, grouping studies into either tube feeding (TF) or standard care (SC). Additionally, another subgroup analysis was conducted comparing studies with protein-energy malnutrition (PEM) patients and studies without PEM patients. RESULTS: The literature search yielded 674 articles of which 36 were included for the meta-analysis. There were no difference in the endpoints between the two study interventions except that PN resulted in more infection when compared with EN (RR =1.09, 95% CI: 1.01-1.18; P=0.03). CONCLUSIONS: Other than increased incidence of infection, PN has not resulted in prolonging the survival, increasing nutrition support complications, or major complications when compared with EN in cancer patients.
BACKGROUND: In cancerpatients, weight loss is an ominous sign suggesting disease progression and shortened survival time. As a result, providing nutrition support for cancerpatients has been proposed as a logical approach for improving clinical outcomes. Nutrition support can be given to patients through enteral nutrition (EN) or parenteral nutrition (PN). The purpose of the review was to compare the outcomes of PN and EN in cancerpatients. METHODS: A literature search was conducted in Ovid MEDLINE and OLDMEDLINE, Embase Classic and Embase, and Cochrane Central Register of Controlled Trials. Studies were included if over half of the patient population had cancer and reported on any of the following endpoints: the percentage of patients that experienced no infection, nutrition support complications, major complications or mortality. Risk ratios (RR) and 95% confidence intervals (CIs) using Review Manager Version 5.3 were calculated. Primary endpoints were stratified according to type of EN for subgroup analysis, grouping studies into either tube feeding (TF) or standard care (SC). Additionally, another subgroup analysis was conducted comparing studies with protein-energy malnutrition (PEM) patients and studies without PEM patients. RESULTS: The literature search yielded 674 articles of which 36 were included for the meta-analysis. There were no difference in the endpoints between the two study interventions except that PN resulted in more infection when compared with EN (RR =1.09, 95% CI: 1.01-1.18; P=0.03). CONCLUSIONS: Other than increased incidence of infection, PN has not resulted in prolonging the survival, increasing nutrition support complications, or major complications when compared with EN in cancerpatients.
Entities:
Keywords:
Parenteral nutrition (PN); cancer patients; enteral nutrition (EN); malnutrition; standard care (SC); tube feeding (TF)
Authors: M Durán-Poveda; P Jimenez-Fonseca; M Sirvent-Ochando; P P García-Luna; J L Pereira-Cunill; B Lema-Marqués; M T Parejo-Arrondo; C Belda-Iniesta Journal: Clin Transl Oncol Date: 2018-03-02 Impact factor: 3.405
Authors: J A Virizuela; M Camblor-Álvarez; L M Luengo-Pérez; E Grande; J Álvarez-Hernández; M J Sendrós-Madroño; P Jiménez-Fonseca; M Cervera-Peris; M J Ocón-Bretón Journal: Clin Transl Oncol Date: 2017-10-17 Impact factor: 3.405
Authors: Ronald Chow; Eduardo Bruera; Jann Arends; Declan Walsh; Florian Strasser; Elisabeth Isenring; Egidio G Del Fabbro; Alex Molassiotis; Monica Krishnan; Leonard Chiu; Nicholas Chiu; Stephanie Chan; Tian Yi Tang; Henry Lam; Michael Lock; Carlo DeAngelis Journal: Support Care Cancer Date: 2019-12-07 Impact factor: 3.603
Authors: Alejandro Sanz-Paris; María Martinez-García; Javier Martinez-Trufero; Julio Lambea-Sorrosal; Fernando Calvo-Gracia; María Elena López-Alaminos Journal: Nutrients Date: 2019-08-13 Impact factor: 5.717
Authors: Andrew E Hendifar; Maria Q B Petzel; Teresa A Zimmers; Crystal S Denlinger; Lynn M Matrisian; Vincent J Picozzi; Lola Rahib Journal: Oncologist Date: 2018-12-27 Impact factor: 5.837