Short summary

Malnutrition in cancer patients is associated with a poor prognosis and is an important predictor of mortality.  

We aim to undertake the effect of supplementation with parenteral nutrition on body composition and quality of life, in patients with advanced gastrointestinal cancer at nutritional risk.

This study will forward knowledge on how to give advanced cancer patients an optimally active life.

Rationale

In most cancer patients a significant weight loss has occurred, at the time of diagnosis. Weight loss leads to a weakened immune system, providing decreased function and decreased quality of life. Malnutrition and weight loss may lead to the patient being unable to receive the oncological palliative care, such as radiation therapy and chemotherapy. Some cancer patients will die from complications of malnutrition and not of their cancer.

Few existing studies provide evidence of the usage of supplemental parenteral nutrition to incurable cancer patients. 

Aim: This study will advance knowledge on the effect of intensive nutritional therapy on muscle breakdown, weight loss and quality of life in non-resectable cancer patient.

Description of the cohort

Eligible in the study will be patients:

• With histologically or radiodiagnostically confirmed GI-cancer, non-resectable.
• At nutritional risk, having lost 5% of body weight during the previous 3 months or has failed to reach their required intake by 25% in the previous 2 weeks.
• at performance status 0-2.
• With an expected survival of a minimum of 3 months.
• Aged over 18 years.

The Patients will be recruited from the out patients clinic of oncology and the Department of Medical Gastroenterology. 

Data and biological material

At the Out-Patient visit, the anthropometric measurements; weight, triceps skinfold as well as measurements of muscle function will be obtained. The measuring of muscle strength will be expressed by hand grip strength (measured with a Hydraulic hand dynamometer) and a 6-minute walking test, which will result in an evaluation of the general performance status.

Body composition will be measured by bioelectrical impedance with a BioScan 920-II.

Blood samples will be taken at each Out-Patient visit in coordination with the Department of Oncology.

The quality of life will be evaluated by the EORTC QLQ C15 PAL.

The quality of life of relatives to patients receiving parenteral nutrition will be evaluated.

Collaborating researchers and departments

Department of Medical Gastroenterology, Odense University Hospital

• Sine Roelsgaard Obling, MD, PhD student
• Professor Jens Kjeldsen, PhD
• Hanne Møller Sørensen
• Sussi Friis Buhl, MD
• Nurse Lene Scheby
• Nurse Jeanette Bjerre Callesen, Degree in Healthcare diploma

Department of Oncology, Odense University Hospital

• Professor Per Pfeiffer, PhD

Internal Medicine, Nykøbing Falster Hospital

• Consultant and Head of Department Benedicte Vibjerg Wilson, MD