High-protein home parenteral nutrition in malnourished oncology patients : a systematic literature review

© 2023. The Author(s)..

INTRODUCTION: Up to 83% of oncology patients are affected by cancer-related malnutrition, depending on tumour location and patient age. Parenteral nutrition can be used to manage malnutrition, but there is no clear consensus as to the optimal protein dosage. The objective of this systematic literature review (SLR) was to identify studies on malnourished oncology patients receiving home parenteral nutrition (HPN) where protein or amino acid delivery was reported in g/kg bodyweight/day, and to compare outcomes between patients receiving low (< 1 g/kg bodyweight/day), standard (1-1.5 g/kg/day), and high-protein doses (> 1.5 g/kg/day).

METHODS: Literature searches were performed on 5th October 2021 in Embase, MEDLINE, and five Cochrane Library and Centre for Reviews and Dissemination databases. Searches were complemented by hand-searching of conference proceedings, a clinical trial registry, and bibliographic reference lists of included studies and relevant SLRs/meta-analyses.

RESULTS: Nineteen publications were included; sixteen investigated standard protein, two reported low protein, and one included both, but none assessed high-protein doses. Only one randomised controlled trial (RCT) was identified; all other studies were observational studies. The only study to compare two protein doses reported significantly greater weight gain in patients receiving 1.15 g/kg/day than those receiving 0.77 g/kg/day.

CONCLUSION: At present, there is insufficient evidence to determine the optimal protein dosage for malnourished oncology patients receiving HPN. Data from non-HPN studies and critically ill patients indicate that high-protein interventions are associated with increased overall survival and quality of life; further studies are needed to establish whether the same applies in malnourished oncology patients.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:32

Enthalten in:

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer - 32(2023), 1 vom: 22. Dez., Seite 52

Sprache:

Englisch

Beteiligte Personen:

Cotogni, Paolo [VerfasserIn]
Shaw, Clare [VerfasserIn]
Jimenez-Fonseca, Paula [VerfasserIn]
Partridge, Dominic [VerfasserIn]
Pritchett, David [VerfasserIn]
Webb, Neil [VerfasserIn]
Crompton, Amy [VerfasserIn]
Garcia-Lorda, Pilar [VerfasserIn]
Shepelev, Julian [VerfasserIn]

Links:

Volltext

Themen:

High protein
Journal Article
Malnutrition
Oncology
Parenteral nutrition
Review
Systematic Review

Anmerkungen:

Date Completed 25.12.2023

Date Revised 17.01.2024

published: Electronic

Citation Status MEDLINE

doi:

10.1007/s00520-023-08218-z

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM366202405