Application of home enteral nutrition and its impact on the quality of life in patients with advanced gastric cancer / 中华胃肠外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the application of home enteral nutrition (HEN) in patients with advanced gastric cancer and its impact on the quality of life.</p><p><b>METHODS</b>Data of 60 consecutive patients with advanced gastric cancer, who could not underwent operation and had relapse metastasis, from June 2010 to June 2012 were retrospectively analyzed. According to familial nutritional pattern, these 60 patients were divided into HEN group (25 cases) receiving home enteral nutritional support and control group (35 cases). HEN patients were supported through jejunostomy tube or nasal gastric tube. Control patients were supported through total parental nutrition or purely eating respectively. All the patients received intravenous chemotherapy and evaluated by Karnofsky index and Spitzer system in the first, third, sixth and twelfth month. In the sixth month, patients were also examined by EORTC QLQ-C30.</p><p><b>RESULTS</b>No significant differences were found between the two groups according to 8 elements containing age, sex, BMI, etc. A total of 53 patients died within one year, including 21 in HEN group and 32 in control group. The Karnofsky scales showed that HEN group scored meanly 57.4, 39.6 and 28.2 in the third, sixth and twelfth month respectively, which were significantly higher than those of control group (45.3, 29.2 and 20.1, P=0.041, P=0.012 and P=0.015 respectively). The Spitzer scales showed that HEN group scored meanly 5.12, 4.04 and 2.54 on average in the third, sixth and twelfth month respectively, which were significantly higher than those of control group (4.32, 3.01 and 1.97, P=0.048, 0.035 and P=0.024 respectively). The EROTC QLQ-C30 scales showed that HEN group scored higher than control group in functional scales (P<0.05), and lower in the symptom scales of short breathing, pain and tired (P=0.025, P=0.044, P=0.036 respectively), while higher in diarrhea (P=0.047).</p><p><b>CONCLUSIONS</b>The quality of life of patients with advanced gastric cancer declines gradually with the nutritional status deteriorating. HEN can be applied to improve the nutritional status and quality of life.</p>