Quality of life after early enteral feeding versus standard care for proven or suspected advanced epithelial ovarian cancer: Results from a randomised trial
Jannah Baker, Monika Janda, Nick Graves, Judy Bauer, Merrilyn Banks, Andrea Garrett, Naven Chetty, Alex J Crandon, Russell Land, Marcelo Nascimento, James L Nicklin, Lewis C Perrin, Andreas Obermair, Jannah Baker, Monika Janda, Nick Graves, Judy Bauer, Merrilyn Banks, Andrea Garrett, Naven Chetty, Alex J Crandon, Russell Land, Marcelo Nascimento, James L Nicklin, Lewis C Perrin, Andreas Obermair
Abstract
Background: Malnutrition is common in patients with advanced epithelial ovarian cancer (EOC), and is associated with impaired quality of life (QoL), longer hospital stay and higher risk of treatment-related adverse events. This phase III multi-centre randomised clinical trial tested early enteral feeding versus standard care on postoperative QoL.
Methods: From 2009 to 2013, 109 patients requiring surgery for suspected advanced EOC, moderately to severely malnourished were enrolled at five sites across Queensland and randomised to intervention (n=53) or control (n=56) groups. Intervention involved intraoperative nasojejunal tube placement and enteral feeding until adequate oral intake could be maintained. Despite being randomised to intervention, 20 patients did not receive feeds (13 did not receive the feeding tube; 7 had it removed early). Control involved postoperative diet as tolerated. QoL was measured at baseline, 6weeks postoperatively and 30days after the third cycle of chemotherapy. The primary outcome measure was the difference in QoL between the intervention and the control group. Secondary endpoints included treatment-related adverse event occurrence, length of stay, postoperative services use, and nutritional status.
Results: Baseline characteristics were comparable between treatment groups. No significant difference in QoL was found between the groups at any time point. There was a trend towards better nutritional status in patients who received the intervention but the differences did not reach statistical significance except for the intention-to-treat analysis at 7days postoperatively (11.8 intervention vs. 13.8 control, p 0.04).
Conclusion: Early enteral feeding did not significantly improve patients' QoL compared to standard of care but may improve nutritional status.
Trial registration: ClinicalTrials.gov NCT00850772.
Keywords: Gynaecological cancer; Malnutrition; Ovarian cancer; Quality of life.
Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.
Source: PubMed