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Total parenteral nutrition and cancer clinical trials
Author(s) -
Klein Samuel,
Simes John,
Blackburn George L.
Publication year - 1986
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19860915)58:6<1378::aid-cncr2820580635>3.0.co;2-s
Subject(s) - medicine , parenteral nutrition , chemotherapy , clinical trial , randomized controlled trial , cancer , radiation therapy , prospective cohort study , gastrointestinal cancer , surgery , colorectal cancer
Twenty‐eight prospective randomized controlled clinical trials evaluating the use of total parenteral nutrition (TPN) in cancer patients were identified through a search of major indexing sources. The data were pooled across studies to increase the ability to detect therapeutic effects. The impact of publication bias and the quality of reporting each trial were used to critically assess the conclusions drawn from the pooled analysis. The authors conclude that TPN may be useful when used preoperatively in patients with gastrointestinal tract cancer. It appears to be beneficial in reducing major surgical complications (pooled P = 0.01) and operative mortality (pooled P = 0.02). No statistically significant benefit from TPN could be demonstrated in survival, treatment tolerance, treatment toxicity, or tumor response in patients receiving chemotherapy or radiotherapy. An increase in the risk of developing an infection in chemotherapy patients given TPN (pooled P > 0.0001) underscores the importance of demonstrating significant benefits in randomized trials before TPN is used routinely in these patients.