終末期がんへの栄養サポート

緩和ケア病棟における終末期がん患者への栄養サポートの効果に関する日本からの論文を紹介します。

Koji Amano, et al. Effect of Nutritional Support on Terminally Ill Patients With Cancer in a Palliative Care Unit. AM J HOSP PALLIAT CARE, Published online before print December 12, 2012, doi: 10.1177/1049909112469273

個別の栄養サポートを行った患者22人とその他の患者41人を、後ろ向きコホート研究（かな？）で比較検討しています。結果ですが、栄養サポート群で褥瘡が有意に少なく、浮腫と抗生剤使用が少ない傾向にありました。栄養サポートが有用な終末期がん患者もいる可能性があるという結論です。

リハよりも栄養サポートの効果を出しにくいセッティングで、こうして論文をまとめるのは素晴らしいと思います。ただ、対照群で褥瘡が多かったのは、対照群にPSが3の方がより多かったせいかもしれません。リハ栄養でもこうして成果を出していければと感じます。

Abstract
The role of nutritional support on terminally ill patients with cancer in a palliative care unit has not been clarified. A total of 63 patients were retrospectively investigated; the patients receiving individualized nutritional support (intervention group [n = 22]) were compared to the others (control group [n = 41]). The intervention group received individualized nutritional support. There were no significant differences in the characteristics of patients between the groups. The prevalence of bedsores was significantly lower in the intervention group (14% vs 46%, P = .012). The prevalence of edema and the use of antibiotic therapies tended to be lower in the intervention group than in the control group (36% vs 54%, P = .19; 14% vs 27%, P = .34, respectively). Some terminally ill patients with cancer in a palliative care unit might benefit from nutritional support.