Effects of parenteral nutrition vs. best supportive nutritional care on quality of life in patients with pancreatic cancer – A secondary analysis of PANUSCO

Abstract

Abstract Purpose Parenteral nutrition (PN) can be an effective treatment to improve the nutritional status of patients with pancreatic cancer, but the effects of PN on quality of life (QoL) are still understudied. Therefore, we aimed at investigating whether best supportive nutritional care (BSNC) in combination with PN at home compared to BSNC alone changed QoL in patients with advanced pancreatic cancer undergoing chemotherapy over a period of seven weeks. Methods n = 12 patients in the PANUSCO study received nutritional counselling only (control group (CG)) and n = 9 patients was also given supportive PN (intervention group (IG)). Primary endpoint was the change of QoL (EORTC-QLQ-C30 and QLQ-PAN26) over seven weeks between the groups. Results There was a significant worsening in social functioning in IG (p = 0.031) and a significant difference between groups in change of social functioning (p = 0.020). In all other domains of QoL, there was no significant difference between groups. Within groups, there was a significant improvement in the domain weight loss in IG (p = 0.031), showing that patients were less worried about their weight being too low. Furthermore, there was a significant difference in the change of BW over time between groups (p < 0.001) with IG showing an increase (p = 0.004) and CG showing no change (p = 0.578). Conclusion The administration of PN had in one of five domains negative consequences on QoL. The decision to administer PN should always be made individually and together with the patient, and the impact on QoL should be included in the decision to administer PN.