The Effectiveness of Artificial Hydration Therapy for Patients With Terminal Cancer Having Overhydration Symptoms Based on the Japanese Clinical Guidelines A Pilot Study

摘要

Background: Recently, there has been a growing interest in the use of artificial hydration therapy (AHT) for patients with terminal cancer. The Japanese Society for Palliative Medicine published the guideline for AHT in 2007, and it was revised in 2013 based on the concept of cancer cachexia. Objectives: The purpose of this study was to evaluate the effects of AHT for patients with terminal cancer having overhydration symptoms based on this revised guideline. Methods: This is a before-and-after study. We retrospectively analyzed 121 patients, of the 523 patients with terminal cancer who were admitted during the last 4 years, who were receiving "inappropriate hydration therapy." We performed guideline-based AHT and examined the effects on the alleviation of hydration-related symptoms, quality of life (QOL), patient satisfaction, and the feeling of benefit from AHT using a numeric rating scale, European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire-C30, satisfaction scale, and benefit scale on day 7 +/- 1 compared to those at baseline. Results: Hydration-related symptoms (nausea: 32, abdominal pain/distention: 35, peripheral edema: 42, and dyspnea: 28 cases) were significantly improved after performing guideline-based AHT (5.35 +/- 1.26 -> 4.00 +/- 1.51, P = .002; 5.41 +/- 1.44 -> 4.12 +/- 1.52; P = .005; 5.16 +/- 1.38 -> 3.29 +/- 1.66; P 4.21 +/- 1.53, P = .002, respectively). The general QOL scores, overall satisfaction, and feeling of benefit were also significantly improved (2.67 +/- 1.21 -> 3.98 +/- 1.55, P 3.48 +/- 1.44, P 4.31 +/- 1.38, P = .0001, respectively). Conclusions: An appropriate AHT could alleviate overhydration-related symptoms and improve the QOL, patient satisfaction, and feeling of benefit.