Efficacy of Enteral and Parenteral Nutrition in Cancer Patients

Abstract

Before attempting to analyze the potential efficacy of the two different routes of administering nutrients to cancer patients, enteral nutrition (EN) versus total parenteral nutrition (TPN), it should be appreciated that patients who are usually fed via a vein are not the same as those who receive EN. If fact, nowadays, the option for TPN only emerges if a patient is not suitable for EN because his/her gut is not working. Consequently the different effects of EN and TPN cannot be attributed only to the administration route of nutrients, but also to the different basic conditions of these 2 groups of patients.There are, however, some exceptions: at the beginning of the era of artificial nutrition, TPN was more developed than EN probably because the impetus of this new approach relied on an urgent need to solve the problems of patients with intestinal failure. In fact, initially TPN was developed in surgical departments to meet the nutritional requirements of patients with short-bowel syndrome or abdominal catastrophes. This translated into the use of TPN also in patients with a working gut, and finally rendered a comparison between TPN and EN not only possible, but even scientifically rational and ethically acceptable. At this point we were roughly in the 1980s.Another field where TPN and EN are frequently compared is the perioperative setting. Nutritional support in the perioperative period is not nutrition in the traditional meaning of the word: it is the attempt to control the metabolic reaction to surgical trauma and to potentiate the defenses of the patient through the administration of nutrients.The indication for nutritional support in this patient population was questioned for a long time and the simple provision of a saline solution for a few days was usually accepted in many institutions. Consequently in the literature there are studies comparing not only different nutritional regimens and Lochs H, Thomas

Enteral (oral or tube administration) nutritional support and eicosapentaenoic acid in patients with cancer: A systematic review

“…anorexia, hypermetabolism, alterations in taste and smell, nausea, (37-39) have generally not been systematic reviews, excluded meta-analyses and, in some cases, have not considered studies on patients with cancer separately from other conditions (37). One review on this topic only considered preoperative studies in cancer patients (38), and another did not separately consider the effects of ETF using standard feeds from 'immunonutrition' feeds (39).…”

Supportive care is mandatory for successful radiotherapy and chemoradiotherapy in patients with head and neck tumors

“…Расчет основных потребностей пациента ориентирован на общее количество потребляемой энергии и количественное соотношение различных субстратов. Необходимое количество калорий чаще всего рассчитывают с учетом его энергетических затрат с ориентиром на предупреждение нарастания дефицита энергии [45,46,83]. Пациентам, получающим лучевое и химиолучевое лечение, оптимально применение смесей, обогащенных жирными кислотами омега-3 и пищевыми волокнами (табл.…”

Nutritional support as an obligatory component of accompanying therapy for head and neck tumors during radiotherapy and chemoradiotherapy

“…Расчет основных потреб-ностей пациента ориентирован на общее количество потребляемой энергии и количественное соотноше-ние различных субстратов. Необходимое количество калорий чаще всего рассчитывается с учетом его энергетических затрат с ориентиром на предупрежде-ние нарастания дефицита энергии [42,45,63]. Для па-циентов, получающих лучевое и химиолучевое лече-ние, является оптимальным применение смесей, обогащенных омега-3 жирными кислотами и пище- [65].…”