Safety and Feasibility of Hypodermoclysis in Advanced Cancer: A Systematic Review and Meta-Analysis

BackgroundClinically assisted hydration in advanced cancer remains controversial, with uncertainty regarding potential benefits and harms near the end of life. Hypodermoclysis offers a less invasive alternative to intravenous hydration, yet safety outcomes have not been clearly quantified.MethodsWe conducted a systematic review and meta-analysis following PRISMA 2020 guidelines to evaluate the safety and feasibility of hypodermoclysis in adults with advanced cancer receiving palliative or hospice care. Randomized and observational studies reporting outcomes related to subcutaneous fluid administration were included. Local infusion-site complications and treatment discontinuation were pooled using random-effects meta-analysis when data were comparable.ResultsFive studies met inclusion criteria, including cohort studies and randomized trials conducted in palliative settings, with 3 studies suitable for quantitative synthesis. Pooled analysis estimated that approximately 17% of patients experienced local infusion-site complications, although events were predominantly mild and rarely required treatment discontinuation. Randomized trials did not consistently demonstrate improvements in symptoms or survival associated with clinically assisted hydration.ConclusionsHypodermoclysis appears to be a feasible and generally safe hydration method in advanced cancer care, with complications typically minor. However, evidence supporting routine hydration remains limited, and decisions should be individualized according to patient goals and symptom burden.