No abstract

Background. Malnutrition worsens health-related quality of life (HRQoL) and the prognosis of patients with advanced cancer. This study aimed to assess the clinical benefits of parenteral nutrition (PN) over oral feeding (OF) for patients with advanced cancer cachexia and without intestinal impairment. Material and Methods. In this prospective multicentric randomized controlled study, patients with advanced cancer and malnutrition were randomly assigned to optimized nutritional care with or without supplemental PN. Zelen's method was used for randomization to facilitate inclusions. Nutritional and performance status and HRQoL using the European Organization for Research and Treatment of Cancer QLQ-C15-PAL questionnaire were evaluated at baseline and monthly until death. Primary endpoint was HRQoL deterioration-free survival (DFS) defined as a definitive deterioration of ≥10 points compared with baseline, or death.

Every year in France 100 inmates die in prison from illness, but their experiences with end of life (EOL) have not been investigated to date. The purpose of this article is to highlight the realities regarding inmates at the end of life, putting into perspective the viewpoints of the sick prisoners with those of the health and correctional professionals accompanying them. Based on qualitative research, the challenge is to identify potential barriers to palliative care for inmates in order to consider possible improvements. The study results reveal that EOL inmates were not fully considered as patients and did not benefit from a comprehensive palliative care approach. For most dying inmates, and according to many health professionals, compassionate release on medical grounds remains the best approach to deal with EOL issues.