Parenteral Nutrition in Patients with Incurable Cancer: Exploring the Heterogenous and Non-Randomised Clinical...

Area of Science:

• Oncology
• Clinical Nutrition
• Palliative Care

Background:

• Limited evidence exists for optimal parenteral nutrition (PN) in incurable cancer patients.
• Current guidelines are vague, leading to inconsistent clinical practices.

Purpose of the Study:

• To describe the real-world practices and outcomes of PN administration in Norwegian hospitals for patients with incurable cancer.

Main Methods:

• Retrospective multicentre study of 507 deceased patients (>18 years) who received PN between 2011 and 2017.
• Data collected from PN initiation to death; descriptive analyses performed.

Main Results:

• Most patients had gastrointestinal cancers; indications for PN included insufficient intake and GI malfunction.
• Median PN dose was 53% of energy needs, with most patients receiving complementary intake.
• Common symptoms included nausea and vomiting, though 15% reported improved wellbeing; imminent death was the main discontinuation reason.

Conclusions:

• A significant proportion of patients (up to 80%) would not meet criteria for previous PN trials.
• Practices are heterogeneous, emphasizing the need for individualized PN in palliative care.
• Development of pragmatic, patient-centered protocols is warranted to bridge the gap between clinical trials and practice.