Oral nutritional support can shorten the duration of parenteral hydration in end-of-life cancer patients: a randomized controlled trial

Nutr Cancer. 2015;67(1):105-11. doi: 10.1080/01635581.2015.976312. Epub 2014 Dec 1.

Abstract

Tube feeding or hydration is often considered for end-of-life cancer patients despite the negative effects on quality of life. The efficacy of oral nutritional support in this setting is unknown. We conducted a randomized trial to compare the efficacies of an amino acid jelly, Inner Power® (IP), and a liquid enteral product, Ensure Liquid® (EL), in terminally ill cancer patients. We randomly assigned patients to 3 arms: EL, IP, and EL+IP. The primary endpoint was drip infusion in vein (DIV)-free survival, which was defined as the duration from nutritional support initiation to administration of parenteral hydration. Twenty-seven patients were enrolled in the study, of whom 21 were included in the intention-to-treat analysis. The median age of the subjects was 69 yr. There were significant differences between the arms with regard to the median DIV-free survival (0.5, 6.0, and 4.5 days in the EL, IP, and EL + IP arms, respectively; P = 0.05). The median overall survival was 7, 9, and 8 days in the EL, IP, and EL + IP arms, respectively. IP may shorten the duration of parenteral hydration in terminally ill cancer patients and does not affect their survival.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Amino Acids / administration & dosage
  • Combined Modality Therapy
  • Deglutition Disorders / etiology*
  • Deglutition Disorders / physiopathology
  • Dehydration / etiology
  • Dehydration / prevention & control*
  • Dietary Sucrose
  • Enteral Nutrition* / adverse effects
  • Female
  • Fluid Therapy* / adverse effects
  • Food, Formulated
  • Humans
  • Infusions, Intravenous
  • Intention to Treat Analysis
  • Japan
  • Male
  • Middle Aged
  • Neoplasms / mortality
  • Neoplasms / physiopathology*
  • Quality of Life*
  • Rehydration Solutions / administration & dosage
  • Rehydration Solutions / therapeutic use
  • Survival Analysis
  • Terminal Care*
  • Time Factors

Substances

  • Amino Acids
  • Dietary Sucrose
  • Rehydration Solutions
  • Ensure formulated food