Parenteral Nutrition Therapy in Patients With Incurable Cancer

Study Overview
=================
Brief Summary
-----------------
Parenteral nutrition (PN) treatment in patients with incurable cancer is understudied and the level of evidence for clinical meaningful effects is weak. Guidelines give few specific recommendations regarding which patients with incurable cancer that should be offered PN treatment. According to the Norwegian prescription database, the use of parenteral nutrition has more than doubled in the period 2004-2015. These numbers do not separate between diagnoses and medical conditions, so the current use of medical nutrition in cancer patients in Norway is not known. The decision to initiate parenteral nutrition is taken at hospitals, whereupon the patient returns home to their respective municipalities and receives follow-up by the home care service. There are often uncertainties about the duration of treatment, as patients' clinical condition can change rapidly. One major challenge health care professionals face is to decide when to end medical nutrition therapy. Patients and relatives may experience fear that discontinuation of medical nutrition accelerates death, while health care professionals often experience that nutrition in many cases does not help and inflicts negatively on patients' condition. This makes communication concerning end of nutritional treatment between health care professionals at several health care levels, patients and their relatives challenging. There is a need for a stronger evidence base considering the effect of medical nutrition in patients with incurable cancer. To be able to study the effect of PN treatment, more studies on clinical practice of PN treatment to patients with incurable cancer is needed. Aspects like indication for use, dosage and duration of PN treatment is poorly described in the available literature. Thus, the aim of this study is to describe indications for use of PN, duration of treatment, reasons for discontinuation, method of administration, possible benefits and complications as well as survival.

Official Title
-----------------
Parenteral Nutrition Therapy in Patients With Incurable Cancer - A Retrospective Analysis of Current Practice

Conditions
-----------------
Neoplasms, Terminal Illness

Intervention / Treatment
-----------------
* Other: Parenteral nutrition


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Patient with incurable cancer Use of parental nutrition in palliative setting Exclusion Criteria: Still alive

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Parenteral nutrition<br> | Other: Parenteral nutrition<br>* Parenteral nutrition treatment in palliative care<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Received dose of parenteral nutrition | Dose is measured in kcal/kg/day | From start of parenteral nutrition treatment to termination of parenteral nutrition, up to 3 years | 
| Duration of treatment | Duration is measured in days | From start of parenteral nutrition treatment to termination of parenteral nutrition, up to 3 years | 
| Survival | Survival is measured in days | From start of parenteral nutrition treatment to date of death, up to 7 years | 
| Indication for use of parenteral nutrition | Registered indication for use of parenteral nutrition treatment | Baseline | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Parenteral nutrition, Medical Records, Palliative Care, Disease Progression