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Effectiveness of two methods of parenteral nutrition support in improving muscle mass of children with neuroblastoma or Wilms' Tumor. A randomized study
Author(s) -
Rickard Karyl A.,
Becker Mary Corcoran,
Loghmani Emily,
Grosfeld Jay L.,
Godshall Barbara Jaeger,
Weetman Robert M.,
Coates Thomas D.,
Lingard Catherine Detamore,
White Nancy Matchett,
Foland Beth Bartlett,
Yu PaoLo,
McGuire Warren,
Provisor Arthur J.,
Oei TJien O.,
Baehner Robert L.
Publication year - 1989
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(19890701)64:1<116::aid-cncr2820640121>3.0.co;2-l
Subject(s) - medicine , parenteral nutrition , neuroblastoma , wilms' tumor , anthropometry , gastroenterology , enteral administration , randomized controlled trial , surgery , pediatrics , genetics , biology , cell culture
The short‐term and long‐term effectiveness of central parenteral nutrition (CPN) versus peripheral parenteral nutrition (PPN) in improving muscle mass (arm muscle area [AMA]) was evaluated for 24 malnourished children with newly diagnosed Stage IV neuroblastoma (n = 14) or Stages II‐V Wilms' tumor (n = 10). Patients were randomized to either CPN or PPN plus enteral nutrition (EN: intense nutrition counseling, oral foods, and supplements) for 4 weeks followed by EN until week 10. Oncologic treatment was similar for each tumor type. Dietary, anthropometric, and biochemical measurements were obtained at weeks 0, 4, and 10. During weeks 1 through 4, energy (CPN:100 ± 4; PPN:96 ± 4% of healthy children) and protein (CPN:2.5 ± 0.1; PPN2.7 ± 0.2 g/kg) intakes of the two groups did not differ. The AMA increased ( P < 0.05) with 4 weeks of CPN but not with PPN; changes thereafter with EN were not significant. Weight ( P < 0.05) and triceps skinfolds ( P < 0.01) increased with 4 weeks of PN in both groups and decreased with EN thereafter ( P < 0.01) but were higher at week 10 than diagnosis. Increases in albumin in both groups reached significance at week 10 ( P < 0.05). These data show that CPN improves AMA in malnourished children with neuroblastoma or Wilms' tumor when energy and protein intakes are adequate. The AMA gains can be maintained thereafter with EN.