[Our experiences of best supportive care for gastric cancer patients]

The literature contains only a small number of reports concerning best supportive care(BSC)in gastric cancer. With the progress of social healthcare systems supporting medical care at home, the quality and performance of BSC at present are different from those in the mid-1990s, when the previous reports were published. We evaluated the quality and performance of BSC in gastric cancer patients in collaboration with visiting nurses.

This study comprised 17 gastric cancer patients receiving BSC between March 2005 and April 2009. Baseline characteristics were age, sex, performance status, and main disease site at entry. Except for one patient who died of other than gastric cancer, types of nutritional support whenever needed during the BSC period were divided into two categories; drip infusion through peripheral vein (peripheral group, n=7) and parenteral or enteral nutrition through a central venous catheter or gastrostomy (hyperalimentation group, n=9). The main outcome measures were overall survival and survival according to the type of nutritional support, as well as quality and performance of BSC.

Mean age and mean PS were 76 years old and 2. 9, respectively, with incidences of > or =75 years old and PS> or =3 accounting for 71% and 59%, respectively. Overall MST was 175 days, which was longer than earlier reported. MST of the hyperalimentation group (190 days)was significantly (p<0.04) longer than that of the peripheral group. Fourteen patients (88%) could stay at home during at least part of the BSC period, and among them, 10 patients received home visiting care by a doctor and/or nurse, and 7 patients (70%) died at home. Eight patients (89%) in the hyperalimentation group received home care visits.

These results suggest that home care hyperalimentation by visiting nurses prolongs BSC patient survival in gastric cancer. Domiciliary care realizes hyperalimentation and provides comprehensive home-care during BSC period.