[Enteral nutrition in cancer patients]

The significance of nutritional management in patients with malignant tumors is under-recognized due to the lack of clear evidence of a direct link with survival rate. However, for cancer patients, with markedly reduced food intake continuing for≥7 days or intake of under 60% of estimated energy expenditure for≥10 days, as referred to in the European Society for Clinical Nutrition and Metabolism, rapid implementation of nutritional support constitutes a clinically appropriate intervention. With regard to route of administration, as with other conditions, enteral nutritional management is recommended if the gastrointestinal tract is available. The utility of enteral immunonutrition formulae containing eicosapentaenoic acid and other forms of nutritional management has also recently been reported and further studies are anticipated. However, the principles of nutritional management for cancer patients comprise not simply weight increase or improvement in nutritional markers but the maintenance of patient QOL in ways that include alleviation of symptoms and antitumor therapy side-effects, and decreased risk of infection. Administration routes such as percutaneous endoscopic gastrostomy should therefore also be discussed from this perspective.