1510P Effects and feasibility of home parenteral nutrition (HPN) in cancer patients with or without migrant background

Abstract

HPN is established in cancer patients (pts) due to insufficient food intake and consuming tumor disease. As there is no data in pts with migrant background (MB), this prospective observational study examined feasibility of HPN, influence on QoL and nutrition status of cancer pts with and without MB. Eligibility required ECOG ≥1, life expectancy ≥4 weeks and first time HPN for at least 28 days. MB status was assessed at baseline. At day 1, 14 and 28 validated questionnaires assessed QoL, nutrition status (EORTC-QLQ-C15-PAL, Subjective global assessment (SGA)), as well as feasibility and complications of HPN. To evaluate HPN response, bioimpedance analysis, BMI and weight were measured. Between 05/2015 and 11/2019, 68 pts were included, 17 with MB. Tumor entities were gastric (n = 41), esophageal (n = 20) and other (n = 7), treated in a curative (n = 14) or palliative (n = 54) concept. Overall, 40 pts were able to continue HPN until day 14, 26 pts until day 28. 42 pts left study prematurely due to death (1 with MB/8 overall), worsening of general condition (3/15), dietary improvement (1/2), change of supplier (1/5) and lost to follow up (2/11). Global QoL in all pts was stable from baseline to d14 (n = 36), whereas QoL in pts with MB deteriorated (n = 9). At d28, QoL improved in all pts (n = 23) and was stable in pts with MB (n = 7). In evaluable patients, medical problems associated with HPN occurred in 31% of all pts and 36% of pts with MB. The majority of pts (54%) reported HPN-associated organisational complications without significant difference of pts with (6/10) and without MB (20/38). SGA improvement was detected in all pts regardless of MB. During the course of HPN, there was no significant change in body weight and BMI in all pts, independent from MB. Overall, 59% of pts received HPN for 14 days, only 38% for 28 days. Discontinuation was mainly associated with disease progression. Feasibility and organisational problems are frequent, but did not affect duration of HPN. Assessing HPN prospectively shows defining the ideal point to start HPN appears to be essential for HPN response. MB is not associated with a major difference in incidence of viability, benefit or duration of HPN in our study.