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Parenteral nutrition (PN) is recommended if the prognosis is\u2009&gt;\u20092\u00a0months. An elemental diet (ED) is licensed for strictures in Crohn\u2019s disease but has not been used in malignant bowel obstruction. The aim of this study was to evaluate the use of ED in patients with IBO and provide a proof of concept of ED as an acceptable feeding option.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a mixed-methods single-arm feasibility study. The primary endpoint was to provide a \u2018proof of concept\u2019 of ED as an acceptable feeding option for patients with IBO. Secondary endpoints included taste acceptability, incidences of vomiting and pain, the proportion of women who tolerated ED, the number of cartons drunk, quality of life (QOL) and the number of women treated with chemotherapy. Patients (&gt;\u200918\u00a0years) with CT-confirmed IBO who could tolerate 500\u00a0ml of liquid in 24\u00a0h remained on the trial for 2\u00a0weeks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 29 patients were recruited; of those, 19 contributed to the analysis for the primary endpoint; 13 (68.4%) participants tolerated the ED; 26 patients contributed to MSAS and EORTC QLQ questionnaires at baseline to allow for the assessment of symptoms. At the start of the study, 18 (69%) of patients experienced vomiting, reducing to 4 (25%) by the end of day 15 of the study; 24 (92%) of patients reported pain at consent, reducing to 12 (75%) by the end of day 15. QOL scores improved from 36.2 (95% CI 27.7\u201344.7) at baseline to 53.1 (95% CI 40.3\u201366) at the end of day 15; 16 (84%) participants commenced chemotherapy within the first week of starting ED. The number of cartons across all participants showed a median of 1.3 cartons per day (range 0.8 to 2.5).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ED is well tolerated by patients with IBO caused by gynaecological malignancies and may have a positive effect on symptom burden and QOL.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00520-024-08709-7","type":"journal-article","created":{"date-parts":[[2024,8,2]],"date-time":"2024-08-02T01:02:21Z","timestamp":1722560541000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Can we improve the management of inoperable malignant bowel obstruction? Results of a feasibility study of elemental diet as an alternative to parenteral nutrition in patients with advanced gynaecological cancer"],"prefix":"10.1007","volume":"32","author":[{"given":"Lindsey L.","family":"Allan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon S.","family":"Skene","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kate Bennett","family":"Eastley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Herbertson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleanor","family":"Smith","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agnieszka","family":"Michael","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,8,2]]},"reference":[{"issue":"1","key":"8709_CR1","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1093\/oxfordjournals.annonc.a058345","volume":"4","author":"C Ripamonti","year":"1993","unstructured":"Ripamonti C, De Conno F, Ventafridda V, Rossi B, Baines MJ (1993) Management of bowel obstruction in advanced and terminal cancer patients. 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Int J Womens Health 14:1849\u20131862. https:\/\/doi.org\/10.2147\/IJWH.S366680","journal-title":"Int J Womens Health"}],"container-title":["Supportive Care in Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00520-024-08709-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00520-024-08709-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00520-024-08709-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,14]],"date-time":"2024-08-14T01:12:10Z","timestamp":1723597930000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00520-024-08709-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8]]},"references-count":43,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2024,8]]}},"alternative-id":["8709"],"URL":"https:\/\/doi.org\/10.1007\/s00520-024-08709-7","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-3511930\/v1","asserted-by":"object"}]},"ISSN":["0941-4355","1433-7339"],"issn-type":[{"value":"0941-4355","type":"print"},{"value":"1433-7339","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8]]},"assertion":[{"value":"30 October 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 July 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 August 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical approval was obtained from the Southeast Coast \u2013 Surrey Research Ethics Committee (reference 16\/LO\/2079). The trial was sponsored by Royal Surrey NHS Foundation Trust and was included on the National Institute for Health Research clinical trials portfolio for ovarian cancer.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Lindsey Allan has served on advisory boards for Nutricia Ltd., received speaker honoraria from IPSEN, Viatris, Guildford Advanced Courses and financial support for conference attendances from Nutricia Ltd. Agnieszka Michael has received research support from Innovate UK, MERCK and NIHR, honoraria from Pfizer, IPSEN, GSK and Clovis, and served on advisory boards for GSK, Clovis and ESAI.Non-financial interests: Agnieszka Michael has a leadership role at the British Gynaecological Cancer Society.Simon Skene, Eleanor Smith and Rebecca Herbertson declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"567"}}