TY - JOUR
T1 - Enteral and parenteral nutrition in cancer patients
T2 - A systematic review and meta-analysis
AU - Chow, Ronald
AU - Bruera, Eduardo
AU - Chiu, Leonard
AU - Chow, Selina
AU - Chiu, Nicholas
AU - Lam, Henry
AU - McDonald, Rachel
AU - DeAngelis, Carlo
AU - Vuong, Sherlyn
AU - Ganesh, Vithusha
AU - Chow, Edward
N1 - Publisher Copyright:
© Annals of Palliative Medicine. All rights reserved.
PY - 2016
Y1 - 2016
N2 - Background: In cancer patients, weight loss is an ominous sign suggesting disease progression and shortened survival time. As a result, providing nutrition support for cancer patients has been proposed as a logical approach for improving clinical outcomes. Nutrition support can be given to patients through enteral nutrition (EN) or parenteral nutrition (PN). The purpose of the review was to compare the outcomes of PN and EN in cancer patients. Methods: A literature search was conducted in Ovid MEDLINE and OLDMEDLINE, Embase Classic and Embase, and Cochrane Central Register of Controlled Trials. Studies were included if over half of the patient population had cancer and reported on any of the following endpoints: the percentage of patients that experienced no infection, nutrition support complications, major complications or mortality. Risk ratios (RR) and 95% confidence intervals (CIs) using Review Manager Version 5.3 were calculated. Primary endpoints were stratified according to type of EN for subgroup analysis, grouping studies into either tube feeding (TF) or standard care (SC). Additionally, another subgroup analysis was conducted comparing studies with protein-energy malnutrition (PEM) patients and studies without PEM patients. Results: The literature search yielded 674 articles of which 36 were included for the meta-analysis. There were no difference in the endpoints between the two study interventions except that PN resulted in more infection when compared with EN (RR =1.09, 95% CI: 1.01–1.18; P=0.03). Conclusions: Other than increased incidence of infection, PN has not resulted in prolonging the survival, increasing nutrition support complications, or major complications when compared with EN in cancer patients.
AB - Background: In cancer patients, weight loss is an ominous sign suggesting disease progression and shortened survival time. As a result, providing nutrition support for cancer patients has been proposed as a logical approach for improving clinical outcomes. Nutrition support can be given to patients through enteral nutrition (EN) or parenteral nutrition (PN). The purpose of the review was to compare the outcomes of PN and EN in cancer patients. Methods: A literature search was conducted in Ovid MEDLINE and OLDMEDLINE, Embase Classic and Embase, and Cochrane Central Register of Controlled Trials. Studies were included if over half of the patient population had cancer and reported on any of the following endpoints: the percentage of patients that experienced no infection, nutrition support complications, major complications or mortality. Risk ratios (RR) and 95% confidence intervals (CIs) using Review Manager Version 5.3 were calculated. Primary endpoints were stratified according to type of EN for subgroup analysis, grouping studies into either tube feeding (TF) or standard care (SC). Additionally, another subgroup analysis was conducted comparing studies with protein-energy malnutrition (PEM) patients and studies without PEM patients. Results: The literature search yielded 674 articles of which 36 were included for the meta-analysis. There were no difference in the endpoints between the two study interventions except that PN resulted in more infection when compared with EN (RR =1.09, 95% CI: 1.01–1.18; P=0.03). Conclusions: Other than increased incidence of infection, PN has not resulted in prolonging the survival, increasing nutrition support complications, or major complications when compared with EN in cancer patients.
KW - Cancer patients
KW - Enteral nutrition (EN)
KW - Malnutrition
KW - Parenteral nutrition (PN)
KW - Standard care (SC)
KW - Tube feeding (TF)
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U2 - 10.3978/j.issn.2224-5820.2016.01.01
DO - 10.3978/j.issn.2224-5820.2016.01.01
M3 - Article
C2 - 26841813
AN - SCOPUS:85000936667
SN - 2224-5820
VL - 5
SP - 30
EP - 41
JO - Annals of Palliative Medicine
JF - Annals of Palliative Medicine
IS - 1
ER -