Quality of life after early enteral feeding versus standard care for proven or suspected advanced epithelial ovarian cancer: Results from a randomised trial

被引:15
作者
Baker, Jannah [1 ]
Janda, Monika [1 ]
Graves, Nick [1 ]
Bauer, Judy [2 ]
Banks, Merrilyn [6 ]
Garrett, Andrea [3 ]
Chetty, Naven [4 ]
Crandon, Alex J. [4 ]
Land, Russell [3 ]
Nascimento, Marcelo [5 ]
Nicklin, James L. [3 ]
Perrin, Lewis C. [4 ]
Obermair, Andreas [3 ]
机构
[1] Queensland Univ Technol, Sch Publ Hlth, Inst Hlth & Biomed Innovat, Brisbane, Qld 4001, Australia
[2] Univ Queensland, Sch Human Movement Studies, Ctr Dietet Res C DIET R, Brisbane, Qld 4072, Australia
[3] Univ Queensland, Sch Med, Royal Brisbane & Womens Hosp, Queensland Ctr Gynaecol Canc, Brisbane, Qld 4072, Australia
[4] Mater Publ & Private Hosp, Southport, Qld, Australia
[5] Gold Coast Hosp, Southport, Qld, Australia
[6] Royal Brisbane & Womens Hosp, Dept Nutr & Dietet, Brisbane, Qld 4029, Australia
关键词
Ovarian cancer; Quality of life; Malnutrition; Gynaecological cancer; PARENTERAL-NUTRITION; GASTROINTESTINAL CANCER; FUNCTIONAL ASSESSMENT; MANAGEMENT; HEAD; NECK; MALNUTRITION; OUTCOMES; LENGTH; STAY;
D O I
10.1016/j.ygyno.2015.03.048
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background. Malnutrition is common in patients with advanced epithelial ovarian cancer (EOC), and is associated with impaired quality of life (QoL), longer hospital stay and higher risk of treatment-related adverse events. This phase III multi-centre randomised clinical trial tested early enteral feeding versus standard care on postoperative QoL. Methods. From 2009 to 2013, 109 patients requiring surgery for suspected advanced EOC, moderately to severely malnourished were enrolled at five sites across Queensland and randomised to intervention (n = 53) or control (n = 56) groups. Intervention involved intraoperative nasojejunal tube placement and enteral feeding until adequate oral intake could be maintained. Despite being randomised to intervention, 20 patients did not receive feeds (13 did not receive the feeding tube; 7 had it removed early). Control involved postoperative diet as tolerated. QoL was measured at baseline, 6 weeks postoperatively and 30 days after the third cycle of chemotherapy. The primary outcome measure was the difference in QoL between the intervention and the control group. Secondary endpoints included treatment-related adverse event occurrence, length of stay, postoperative services use, and nutritional status. Results. Baseline characteristics were comparable between treatment groups. No significant difference in QoL was found between the groups at any time point. There was a trend towards better nutritional status in patients who received the intervention but the differences did not reach statistical significance except for the intention-to-treat analysis at 7 days postoperatively (11.8 intervention vs. 13.8 control, p 0.04). Conclusion. Early enteral feeding did not significantly improve patients' QoL compared to standard of care but may improve nutritional status. Crown Copyright (C) 2015 Published by Elsevier Inc. All rights reserved.
引用
收藏
页码:516 / 522
页数:7
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