O'Hanlon, FJ;
Fragkos, KC;
Fini, L;
Patel, PS;
Mehta, SJ;
Rahman, F;
Di Caro, S;
(2020)
Home Parenteral Nutrition in Patients with Advanced Cancer: A Systematic Review and Meta-Analysis.
Nutrition and Cancer
, 73
(6)
pp. 943-955.
10.1080/01635581.2020.1784441.
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Abstract
The use of home parenteral nutrition (HPN) in patients with incurable cancer remains controversial with significant variation worldwide. We aimed to systematically evaluate the literature from 1960 to 2018 examining the use of HPN in advanced cancer patients for all intestinal failure indications and assess the potential benefits/burdens of HPN in this cohort of patients. The primary end point was survival and secondary end points were quality of life and nutritional/performance status. Meta-analysis was performed with a random effects model, where suitable. Of 493 studies retrieved, 22 met the quality inclusion criteria. Studies were mainly conducted in Western countries (Italy, USA, Canada, Germany), including a total of 3564 patients (mean age 57.8 years). Mean duration for HPN was 5.0 mo. Mean overall survival was 7.3 mo. Patients with improved performance status survived for longer on HPN. Quality of life was sparsely reported though there was no observed negative impact of PN. HPN-related complications were reported in eight studies only and were mainly catheter-related blood stream infections. In conclusion, HPN is used for several indications in advanced cancer, though there is significant heterogeneity of results. Disparities in geographical distribution of the studies may reflect variation in accessing HPN.
| Type: | Article |
|---|---|
| Title: | Home Parenteral Nutrition in Patients with Advanced Cancer: A Systematic Review and Meta-Analysis |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1080/01635581.2020.1784441 |
| Publisher version: | https://doi.org/10.1080/01635581.2020.1784441 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Advanced cancer, parenteral nutrition, performance status, systematic review |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10129711 |
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