engleski

Nutritional and pharmacologic support in patients with pancreatic carcinoma - Our results

Introduction: Patients (pts) with carcinoma are often malnourished. Cachexia occurs in 8-84% of cases, depending on primary site of carcinoma (predominantly in gastric and pancreatic cancers ; 84% and 73% respectively). We aimed to asses the impact of nutritional and pharmacologic support on weight gain and its influence on general well-being of our pts. Methods: During 18-month interval, we examined 44 patients with pancreatic carcinoma (18 females, and 26 males, with mean age of 66 &plusmn ; 2.4 years). Metastatic disease was found in 21 and locally advanced disease in 24 pts ; metastatic and locally advanced had 17 pts. In 34 pts some kind of operative procedure was performed, but only 3 pts were radically operated. Dietary intake (Nottingham Screening Tool Score), body weight (BMI), appetite, food intake and Karnofsky Performance Status (KPS) were monitored at baseline (visit 0) and after every 2 weeks during 2-month interval (visits 1, 2, 3, 4). 44 (100%) of pts underwent nutritional counselling, 33 of them (75%) took supplemental enteral feeding and 44 (100%) took megestrol acetate 400 mg per day. Results: At baseline, 44 (100%) of pts had decrease in weight gain (low BMI in 32 pts - 72.7% ; BMI 18-20 in 22 pts - 50% ; < 18 in 10 pts - 22.7%) and poor appetite. In 33 pts (75%) low food intake was recorded. Mean KPS at baseline was 60.2%. After 6 weeks, 38 pts (86.4%) gained their weight and appetite (37-84.1%). KPS was 60.8%. Discussion/Conclusion: With nutritional counseling, supplemental feeding and pharmacologic support we stopped weight loss in our patients. 86.4% of pts increased their weight. 84.1% improved their appetite. These effects were especially represented 4-6 weeks after initial treatment. Because of the side effects, 13.6% of pts stopped taking enteral supplementation. Although our pts increased weight gain, improved appetite and QoL, KPS remained unchanged.

pancreatic carcinoma; nutritional support; pharmacological support

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