Home parenteral nutrition in neuroendocrine tumour intestinal failure: improved quality of life and longevity.

Autor:	Sagar VM; Department of Hepatology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK., Shah T; Department of Hepatology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK., Malhi H; Department of Gastroenterology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK., Parkinson S; Department of Gastroenterology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK., Shetty S; Department of Hepatology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK., Cooper SC; Department of Gastroenterology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK sheldon.cooper@uhb.nhs.uk.
Jazyk:	angličtina
Zdroj:	BMJ supportive & palliative care [BMJ Support Palliat Care] 2020 Sep 11. Date of Electronic Publication: 2020 Sep 11.
DOI:	10.1136/bmjspcare-2020-002562
Abstrakt:	Background: Neuroendocrine tumours (NETs) are neoplastic yet behave differently to typical cancers. Despite often being slow growing, they can lead to significant gastrointestinal complications including intestinal failure (IF). The use of home parenteral nutrition (HPN) in neoplastic conditions is rising, primarily for palliation and bridging through treatments for cancer, but remains a challenging decision with a paucity of high-grade evidence-based guidance. Methods: A retrospective analysis of patients with NET on HPN was performed. Data collected included the cause of IF, complications encountered with HPN and changes in nutritional assessments. Results: Eight patients were identified, all with metastatic NET. Median weight improved following HPN commencement and line sepsis was the sole complication. All patients had stabilisation and optimisation of nutritional and hydration status. Conclusions: HPN is commenced to improve or maintain patients' nutritional status during often lifelong treatment. The principle aim in providing HPN was to improve survival and quality of life. While NETs are cancers, our case series demonstrates the potential of HPN to actively support longer term survival in the subgroup of patients who develop IF. Competing Interests: Competing interests: VMS has received personal fees from Ipsen, and Novartis provided a grant to part fund her research fellow position. SCC has received educational sponsorship from Takeda and Fresenius-Kabi/Calea and honoraria from Novartis. TS has received grants from Ipsen and personal fees from AAA. SS has received personal fees from Faron Pharmaceuticals. Other authors have no conflicting interests to declare. (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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