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  • Title: Total parenteral nutrition in cancer patients.
    Author: Bozzetti F.
    Journal: Curr Opin Support Palliat Care; 2007 Dec; 1(4):281-6. PubMed ID: 18685376.
    Abstract:
    PURPOSE OF REVIEW: To report on how the parenteral nutrition of patients with advanced cancer has evolved and on the current status of research and clinical practice in this field. RECENT FINDINGS: Clinical research has shown that parenteral nutrition may play a role in incurable cancer if patients are expected to die earlier from starvation than from tumour progression. A benefit was recently observed in hypophagic patients requiring supplemental on-demand home parenteral nutrition. There is some doubt that parenteral nutrition plays a palliative role, and data on quality of life are limited. The regimen of parenteral nutrition should be tailored to the needs of the patient, and recent data indicate a reduction in total energy expenditure and water requirements. There is interest in new lipid emulsions enriched with N-3 polyunsaturated fatty acids, which are well utilized by tumour-bearing individuals and may reduce the catabolic drive of cachectic patients. SUMMARY: Future research is addressed at identifying parameters to help in the selection of aphagic/obstructed patients who may benefit from home parenteral nutrition, the early use of supplemental parenteral nutrition in hypophagic patients and developing a better nutritional formulation of lipid emulsions more appropriate for use in advanced cancer patients.
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