Abstract
Aims: For people with advanced pancreatic cancer (PC), debilitating symptoms such as epigastric pain, bloating, loss of appetite and fat-malabsorptive diarrhoea cause poor oral intake and weight loss. These symptoms, and the resulting malnutrition, are associated with worse quality of life (QOL). Evidence suggests that interventions focusing on increasing oral nutrition intake through dietary counselling and/or oral nutrition supplements, have limited effectiveness in preventing decline in nutrition status and QOL. Alternative, more intensive methods of nutrition support such as enteral tube feeding may have greater effectiveness, however this approach is infrequently used during treatment for advanced PC. The aim of this study is to determine the effectiveness of supplemental jejunal feeding for six months during chemotherapy with intensive dietetic counselling delivered via telehealth on QOL, compared with standard care, for people diagnosed with advanced PC.
Methods: The study is a prospective randomised controlled trial, enrolling adults with newly diagnosed inoperable PC. The intervention group will receive ‘top-up’ enteral nutrition via a percutaneous endoscopic gastrostomy with a jejunal extension (PEG-J). The study dietitian will conduct minimum weekly telehealth consults, providing nutrition counselling and facilitation of effective symptom control for the duration of chemotherapy treatment (up to six months). The control group will receive standard nutrition care as part of their cancer treatment. The primary outcome is QOL measured by the EORTC-QLQ C30 summary score. Secondary outcomes include overall survival, changes in chemotherapy dosing, and markers of nutrition status. Outcomes will be measured at baseline, and three- and six-months follow up.
Discussion: This study will provide evidence regarding the impact of achieving nutritional adequacy during chemotherapy treatment for people with advanced PC. Demonstration of effectiveness may shift the treatment paradigm and could translate rapidly into major change in the standard of care of patients.
Methods: The study is a prospective randomised controlled trial, enrolling adults with newly diagnosed inoperable PC. The intervention group will receive ‘top-up’ enteral nutrition via a percutaneous endoscopic gastrostomy with a jejunal extension (PEG-J). The study dietitian will conduct minimum weekly telehealth consults, providing nutrition counselling and facilitation of effective symptom control for the duration of chemotherapy treatment (up to six months). The control group will receive standard nutrition care as part of their cancer treatment. The primary outcome is QOL measured by the EORTC-QLQ C30 summary score. Secondary outcomes include overall survival, changes in chemotherapy dosing, and markers of nutrition status. Outcomes will be measured at baseline, and three- and six-months follow up.
Discussion: This study will provide evidence regarding the impact of achieving nutritional adequacy during chemotherapy treatment for people with advanced PC. Demonstration of effectiveness may shift the treatment paradigm and could translate rapidly into major change in the standard of care of patients.
| Original language | English |
|---|---|
| Article number | 509 |
| Pages (from-to) | 269 |
| Number of pages | 1 |
| Journal | Asia-Pacific Journal of Clinical Oncology |
| Volume | 19 |
| Issue number | S3 |
| Publication status | Published - Nov 2023 |
| Event | Clinical Oncology Society of Australia Annual Scientific Meeting 2023 - Melbourne Convention and Exhibition Centre, Melbourne, Australia Duration: 1 Nov 2023 → 3 Nov 2023 Conference number: 50th https://onlinelibrary.wiley.com/toc/17437563/2023/19/S3 (published abstracts) |
