دورية أكاديمية
أعرض في EDS

Can we improve the management of inoperable malignant bowel obstruction? Results of a feasibility study of elemental diet as an alternative to parenteral nutrition in patients with advanced gynaecological cancer.

التفاصيل البيبلوغرافية
العنوان: Can we improve the management of inoperable malignant bowel obstruction? Results of a feasibility study of elemental diet as an alternative to parenteral nutrition in patients with advanced gynaecological cancer.
المؤلفون: Allan LL; Royal Surrey NHS Foundation Trust, Egerton Road, Guildford, GU2 7XX, United Kingdom., Skene SS; Surrey Clinical Trials Unit, School of Biosciences, University of Surrey, Egerton Road, Guildford, GU2 7XP, United Kingdom., Eastley KB; Surrey Clinical Trials Unit, School of Biosciences, University of Surrey, Egerton Road, Guildford, GU2 7XP, United Kingdom., Herbertson R; University Hospitals Sussex NHS Foundation Trust, Royal Sussex Hospital, Eastern Road, Brighton, BN2 5BE, United Kingdom., Smith E; Royal Surrey NHS Foundation Trust, Egerton Road, Guildford, GU2 7XX, United Kingdom., Michael A; Royal Surrey NHS Foundation Trust, Egerton Road, Guildford, GU2 7XX, United Kingdom. a.michael@surrey.ac.uk.; Surrey Clinical Trials Unit, School of Biosciences, University of Surrey, Egerton Road, Guildford, GU2 7XP, United Kingdom. a.michael@surrey.ac.uk.
المصدر: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer [Support Care Cancer] 2024 Aug 02; Vol. 32 (8), pp. 567. Date of Electronic Publication: 2024 Aug 02.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Springer International Country of Publication: Germany NLM ID: 9302957 Publication Model: Electronic Cited Medium: Internet ISSN: 1433-7339 (Electronic) Linking ISSN: 09414355 NLM ISO Abbreviation: Support Care Cancer Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Berlin : Springer International, c1993-
مواضيع طبية MeSH: Feasibility Studies* , Quality of Life* , Intestinal Obstruction*/etiology , Intestinal Obstruction*/therapy , Genital Neoplasms, Female*/complications , Parenteral Nutrition*/methods , Food, Formulated*, Humans ; Female ; Middle Aged ; Aged ; Adult ; Aged, 80 and over
مستخلص: Purpose: Nutrition support in inoperable bowel obstruction (IBO) remains challenging. Parenteral nutrition (PN) is recommended if the prognosis is > 2 months. An elemental diet (ED) is licensed for strictures in Crohn's disease but has not been used in malignant bowel obstruction. The aim of this study was to evaluate the use of ED in patients with IBO and provide a proof of concept of ED as an acceptable feeding option.
Methods: This was a mixed-methods single-arm feasibility study. The primary endpoint was to provide a 'proof of concept' of ED as an acceptable feeding option for patients with IBO. Secondary endpoints included taste acceptability, incidences of vomiting and pain, the proportion of women who tolerated ED, the number of cartons drunk, quality of life (QOL) and the number of women treated with chemotherapy. Patients (> 18 years) with CT-confirmed IBO who could tolerate 500 ml of liquid in 24 h remained on the trial for 2 weeks.
Results: A total of 29 patients were recruited; of those, 19 contributed to the analysis for the primary endpoint; 13 (68.4%) participants tolerated the ED; 26 patients contributed to MSAS and EORTC QLQ questionnaires at baseline to allow for the assessment of symptoms. At the start of the study, 18 (69%) of patients experienced vomiting, reducing to 4 (25%) by the end of day 15 of the study; 24 (92%) of patients reported pain at consent, reducing to 12 (75%) by the end of day 15. QOL scores improved from 36.2 (95% CI 27.7-44.7) at baseline to 53.1 (95% CI 40.3-66) at the end of day 15; 16 (84%) participants commenced chemotherapy within the first week of starting ED. The number of cartons across all participants showed a median of 1.3 cartons per day (range 0.8 to 2.5).
Conclusion: ED is well tolerated by patients with IBO caused by gynaecological malignancies and may have a positive effect on symptom burden and QOL.
(© 2024. The Author(s).)
References: J Hum Nutr Diet. 2014 Jun;27(3):207-18. (PMID: 24313460)
Am J Hosp Palliat Care. 2011 Dec;28(8):576-82. (PMID: 21504999)
Int J Palliat Nurs. 2001 Oct;7(10):474-81. (PMID: 11923747)
Eur J Cancer. 1994;30A(9):1326-36. (PMID: 7999421)
J Surg Oncol. 2014 Nov;110(6):666-9. (PMID: 24986323)
Cochrane Database Syst Rev. 2014 Apr 23;(4):CD006274. (PMID: 24760679)
Dig Liver Dis. 2009 Jun;41(6):390-4. (PMID: 18945653)
J Clin Gastroenterol. 2014 Oct;48(9):790-5. (PMID: 24440935)
Clin Nutr. 2017 Feb;36(1):11-48. (PMID: 27637832)
J Pain Symptom Manage. 2014 Jul;48(1):75-91. (PMID: 24798105)
Clin Nutr. 2023 Oct;42(10):1940-2021. (PMID: 37639741)
Int J Womens Health. 2022 Dec 28;14:1849-1862. (PMID: 36597479)
Oncologist. 2020 May;25(5):e843-e851. (PMID: 32212354)
J Hum Nutr Diet. 2020 Aug;33(4):550-556. (PMID: 32026525)
Oncol Lett. 2012 Nov;4(5):883-888. (PMID: 23162616)
JCO Oncol Pract. 2020 Aug;16(8):483-489. (PMID: 32240072)
BMJ Support Palliat Care. 2024 Jan 08;13(e3):e515-e527. (PMID: 38557409)
ESMO Open. 2021 Jun;6(3):100092. (PMID: 34144781)
Support Care Cancer. 2021 Dec;29(12):8089-8096. (PMID: 34390398)
Clin Nutr. 2015 Oct;34(5):825-37. (PMID: 25288565)
J Pain Symptom Manage. 2007 Sep;34(3):237-43. (PMID: 17606360)
Crit Rev Oncol Hematol. 2019 Jul;139:96-107. (PMID: 31150954)
Gynecol Oncol. 2020 Jun;157(3):745-753. (PMID: 32217004)
J Clin Epidemiol. 2000 Mar 1;53(3):297-306. (PMID: 10760641)
Clin Nutr. 2023 Mar;42(3):411-430. (PMID: 36796121)
Support Care Cancer. 2022 Apr;30(4):2983-2992. (PMID: 34665311)
J Oncol Pract. 2017 Jul;13(7):426-434. (PMID: 28697317)
Eur J Surg Oncol. 2014 Jul;40(7):899-904. (PMID: 24268761)
Eur J Surg Oncol. 2019 Dec;45(12):2319-2324. (PMID: 31378418)
Clin Nutr. 2021 May;40(5):2898-2913. (PMID: 33946039)
Clin Nutr. 2021 May;40(5):3210-3220. (PMID: 33640206)
J Clin Oncol. 2004 Jan 1;22(1):199-201. (PMID: 14701785)
J Hum Nutr Diet. 2004 Dec;17(6):543-5. (PMID: 15546432)
Cochrane Database Syst Rev. 2016 Jan 04;(1):CD002764. (PMID: 26727399)
J Clin Epidemiol. 2016 Jan;69:79-88. (PMID: 26327487)
Aliment Pharmacol Ther. 1997 Aug;11(4):735-40. (PMID: 9305483)
Ann Oncol. 1993 Jan;4(1):15-21. (PMID: 8435356)
معلومات مُعتمدة: PS-SurreyAM22 Target Ovarian Cancer
فهرسة مساهمة: Keywords: Elemental diet; Inoperable bowel obstruction; Ovarian cancer; Parenteral nutrition
تواريخ الأحداث: Date Created: 20240802 Date Completed: 20240802 Latest Revision: 20240816
رمز التحديث: 20240816
مُعرف محوري في PubMed: PMC11297088
DOI: 10.1007/s00520-024-08709-7
PMID: 39093327
قاعدة البيانات: MEDLINE
الوصف
تدمد:1433-7339
DOI:10.1007/s00520-024-08709-7