PP297 - SYMPTOM DEVELOPMENT DURING PARENTERAL NUTRITION IN PATIENTS WITH INCURABLE CANCER
PP297
SYMPTOM DEVELOPMENT DURING PARENTERAL NUTRITION IN PATIENTS WITH INCURABLE CANCER
M. Erichsen1,*, T. S. Solheim2,3, I. O. Ottestad4,5, I. Paur1,6, R. F. Sande7, A. Nygard8, E. H. Markhus9,10, L. Thoresen3, M. Thronæs3,11, R. J. Tangvik10,12, K. Sygnestveit6,12, P. Hansson1,13, C. Vestnor14, G. Jakobsen3, Ø. Paulsen15,16,17, E. T. Løhre2,3,11, T. R. Balstad1,2,3
1Department of Clinical Medicine, Metabolism and Clinical Nutrition Research Group, UiT The Arctic University of Norway, Tromsø, 2Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU – Norwegian University of Science and Technology, 3Cancer Clinic, St. Olavs hospital, Trondheim University Hospital, Trondheim, 4Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, 5The Clinical Nutrition Outpatient Clinic, Section of Clinical Nutrition, Department of Clinical Service, Division of Cancer Medicine, 6Norwegian National Network for Disease-Related Undernutrition, and Section of Clinical Nutrition, Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, 7Norsk Helsenett SF, Trondheim, 8Cancer and Hematology Center, Vestfold Hospital Trust, Tønsberg, 9Department of Medicine, Section of Clinical Nutrition, Haukeland University Hospital, 10Centre for Nutrition, Department of Clinical Medicine, Faculty of Medicine, 11Centre for Crisis Psychology, Faculty of Psychology, University of Bergen, 12Department of Research and Development, Haukeland University Hospital, Bergen, Norway, 13Department of Food and Nutrition and Sport , University of Gothenburg, Gothenburg, Sweden, 14Department of Public Health and Nursing, NTNU – Norwegian University of Science and Technology, Trondheim, 15Palliative Care Unit, Department of Medicine, Telemark Hospital Trust, Skien, 16European Palliative Care Research Centre (PRC), Department of Oncology, Oslo University Hospital, 17Institute of Clinical Medicine, University of Oslo, Oslo, Norway
Rationale: The use of parenteral nutrition (PN) in patients with incurable cancer is controversial due to concerns about effects and impact on symptom burden. The aim of this study was to describe symptom intensity changes during routine PN treatment.
Methods: In four hospitals, retrospective data were collected from medical records for 517 patients with incurable cancer in whom PN was initiated. Symptom intensity was assessed using the Edmonton Symptom Assessment System (ESAS, scored on a 0–10 numeric rating scale (NRS)). Change was evaluated at two levels: group-level mean/median change, and patient-level clinically meaningful change (≥1 point NRS difference). Factors associated with clinically meaningful change were explored using ANCOVA (cancer type or treatment, age, and inflammation). ClinicalTrials.gov ID: NCT04456647.
Results: ESAS data were available for 232 patients; 59 had repeated assessments. Mean age was 62 years, 44% were women and 59% had gastrointestinal cancers. Prior to PN initiation, symptom burden was highest for appetite loss, tiredness, drowsiness and reduced well‑being (median NRS score >5). During PN, tiredness, drowsiness, nausea and well-being improved significantly (all p<0.05), with 45-57% achieving clinically meaningful improvement. No factors associated with improvements or worsening were identified. Median (IQR) survival from PN initiation among patients with repeated measurements was 61 (36-128) days.
Conclusion: PN was not associated with worsening of overall symptom burden, and clinically meaningful improvements were observed for well‑being. Decisions about PN in incurable cancer should include systematic symptom assessment, as symptom burden is a core component of quality of life.
Disclosure of Interest: None declared