OBJECTIVE
To evaluate the effectiveness of enteral nutrition in an outpatient setting in palliative care patients with malignant neoplasms (MNPs) of the stomach, lips, oral cavity, and pharynx.
SUBJECTS AND METHODS
A retrospective comparative study was conducted, which included 288 cancer patients who received specialized palliative care. In addition to the basic diet, Group 1 (n=155) patients received specialized enteral nutrition formulas (ENFs), Group 2 (n=133) had a therapeutic diet only. Data on the localization of MNPs, the age and sex structure of the patients, the duration, volume, and tolerability of enteral nutrition were analyzed. Weight and body mass index (BMI) changes were comparatively estimated. The investigators studied the subjective assessment of the organoleptic qualities of consumed ENFs, taste preferences and adherence to enteral nutrition in the patients, according to the localization of MNPs. The changes in quality of life in the patients were assessed according to the ECOG scale.
RESULTS AND DISCUSSION
Analyzing data from the follow-up of palliative care patients with MNPs of the lips, oral cavity, pharynx, and stomach showed that as much as 39% had at diagnosis a BMI less than 20 kg/m2 (12% had less than 17 kg/m2). There was a direct correlation of BMI changes with the use of ENFs. In Group 1 who used ENFs, BMI displayed a less pronounced decrease dynamics than the mean BMI values in the control group patients who at 3-month follow-up showed a more significant reduction in weight and BMI that was a 6.4% increase in Group 1.
CONCLUSION
Nutritional support for palliative care patients, by using specialized ENFs as an additional feeding source for at least 3 months, significantly reduces the magnitude of body weight loss, which is directly associated with their better quality of life compared to the control group of patients. The additional use of specialized ENFs (sipping) improves quality of life in patients with MNPs: 46% of patients reported improvement; and the positive subjective assessment of their quality of life almost doubled (from 28% to 52%). Sensory taste preferences in palliative care patients should be taken into account when prescribing ENFs. The most popular ENFs were those with cappuccino (44%) and neutral (19%) flavors.