A Feasibility Study to Investigate the Effect of Nutritional Support for Advanced Cancer Patients in an Inpatient Hospice in Japan

Abstract

Backgrounds: There has been no prospective study to investigate the effect of nutritional sup-port for advanced cancer patients in inpatient hospices. Therefore, we conducted a prospective observational study to explore the feasibility of investigating the effect of nutritional support for advanced cancer patients in an inpatient hospice.
Methods: We prospectively collected the following data: performance status, results of blood tests, calorie and protein intake, body weight, skeletal muscle mass, and Functional Assessment of Anorexia/Cachexia Therapy (FAACT) on the 1st day of admission and every 2 weeks. All patients were followed-up to their discharge or 4 weeks. Primary endpoint was percentage of patients who completed the intervention. Secondary endpoints were overall survival and improvement of Karnofsky Performance Status (KPS) in the 2nd week. Subgroup analysis was performed by dividing patients into 3 groups with change of KPS in the second week (improving, maintaining, and deteriorating KPS groups).
Results: A total of 43 patients met the inclusion criteria, and among them, 14 refused to partici-pate. Thus, 29 were analyzed in the present study. The percentage of patients who completed the intervention in the 2nd week was 93.1% and in the 4th week 44.8%. Sixteen patients, 55.2%, were alive 4 weeks. The KPS improvement rate was 41.4%. The 29 patients were divided into improving KPS (n=12), maintaining KPS (n=9), and deteriorating KPS (n=8). All patients in improving KPS and 4 patients in maintaining KPS were alive 4 weeks. Survival decreased with deterioration of KPS (p<0.001). Calorie/protein sufficiency rate and FAACT score of patients in improving KPS group temporarily improved in the 2nd week.
Conclusions: This study indicated the feasibility of conducting trials to investigate the effect of nutritional support for advanced cancer patients in an inpatient hospice.