Total parenteral nutrition for home therapy in cancer patients]

Home parenteral nutrition (HPN) was used in 14 cancer patients within a 4-yr and 4-month period. Indications included severe malabsorption, short bowel syndrome, radiation enteritis, and malignancies. The mean duration of HPN was 184 days (range: 21-706 days). HPN duration for patients with benign causes (BP) was longer [427 days (range: 176-706 days)] than for cancer-related patients (CP) [49 days (range: 21-121 days)]. The mean catheter life spans to date for BP and CP have been 596 days (range: 187-1173 days) and 127 days (range: 73-278 days), respectively. Serious catheter problems occurred 4 times in BP with the external catheter. Metabolic complications with clinical symptoms occurred in one BP who had short bowel syndrome. We followed with an evaluation of the quality of life of HPN patients. Three in 14 cases returned to work, two of them part time, and two others did most of the housekeeping, but 9 remained at home receiving only outpatient treatment. Some physical distress was recorded in all but one case. We concluded that HPN for cancer patients is a relatively safe, effective means of improving and maintaining the nutritional status, and it can reduce the length of hospitalization. We attempted to evaluate whether these patients were able to achieve a meaningful and satisfactory social and familial life. Our study was not sufficient to assess the psychological and social problems. We should establish criteria for quality of life to evaluate overall satisfaction with conditions of life under HPN.