Studio multicentrico della Regione Piemonte sulla Nutrizione Parenterale Domiciliare in pazienti oncologici non in fase terapeutica attiva

Aim of the study: To assess the requirements for Home Parenteral Nutrition (HPN) in advanced cancer patients. To evaluate nutritional status, quality of life and complica- tions of these patients. Type of study: Multicentric, prospective. Patients and Methods: Seventy subjects with advanced cancer chosen in accordance with crite- ria established by the Therapeutic Unit (Nutritionists, Oncologists, Family Doctors). We studied the requirements of patients living in the geographical area of Turin, the nutritional state by Patient Generated Subjective Global Assessment (PG-SGA), the quality of life by Ther- apy Impact Questionnaire (TIQ) and HPN complications. Results: From October 2000 to November 2001 seventy patients (37 females, 33 males), age 60 (28-87) yrs, were included in the study. The requirements for HPN were calculated as 5 per million inhabitants. We found that 70% were affected by intestinal obstruction and 30% were seriously malnourished. The survival rate (Kaplan Meyer curve) was 70% after 1 month, 43% (2 months), 12% (6 months), 5% (1 year), whereas the oral rehabilitation was 12%. In the 27 patients who survived > 60 days we observed a median increase of 1.2 kg in body weight and no increase in serum albumin. The PG-SGA improved in 37% of the subjects while the quality of life (TIQ) in 31.5% of the patients. The overall HPN complication rate was 19%; the inci- dence of catheter sepsis was 0.5/y HPN. Conclusions: HPN in advanced cancer patients can be safely carried out, even though it is es- sential that inclusion criteria and nursing procedures be improved. The results on the nutrition- al status, performance index and quality of life are encouraging, and justify formal regional de- velopment of the program. (RINPE 2002; 20: 98-107)