The volume of hydration in terminally ill cancer patients with hydration-related symptoms: a prospective study

Recently, there has been a growing interest in the use of artificial hydration therapy (AHT) for terminally ill cancer patients. Some studies have demonstrated that appropriate hydration can contribute to patient comfort; however, few studies have examined the effects of volume reduction on patient symptoms and quality of life (QOL).

This study aimed to clarify the effects of reducing the volume of artificial hydration based on the Japanese guideline in terminally ill cancer patients with hydration-related symptoms on the alleviation of various symptoms and QOL.

Of the 273 terminally ill cancer patients who were transferred from other hospitals for palliative care over the last 2 years, 78 patients who presented with hydration-related symptoms at the time of admission were analyzed. We performed guideline-based AHT and reduced the volume of hydration with standard pharmacological therapy. The effects on the alleviation of hydration-related symptoms and QOL were examined using a numeric rating scale and item 30 of the European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire-C30 (EORTC QLQ-C30) to compare values measured before and one week after AHT. We also evaluated patient satisfaction and the feeling of benefit from hydration one week after the study commenced.

Hydration-related symptoms (nausea, 16 cases; abdominal pain/distention, 22 cases; peripheral edema, 32 cases; and dyspnea, 15 cases) were significantly improved after performing guideline-based AHT (p=0.024, p=0.003, p<0.0001, and p=0.046, respectively). General QOL scores, global satisfaction, and feeling of benefit were also significantly improved after performing guideline-based AHT (p<0.0001, p=0.0001, and p=0.001, respectively).

The provision of appropriate guideline-based AHT can contribute to alleviating hydration-related symptoms and improving QOL in terminally ill cancer patients.