The efficacy of
total parenteral nutrition (TPN) in the protection of body composition, when given as an adjuvant to CVB (
cisplatin-
vinblastine-
bleomycin) treatment to patients with testicular
teratocarcinoma, was investigated. Twenty-three patients without previous
malnutrition were randomized to receive either TPN or spontaneous oral intake only during their
hospital stay, in the course of a total treatment period of 10 weeks. The patients spent weeks 1, 4, 7, and 10 in the hospital to undergo
chemotherapy. Energy and
nitrogen intakes were profoundly decreased in the spontaneous oral-intake group, whereas the intakes decreased in the TPN group only at home when they relied on oral intake. In spite of the cytotoxic drugs, the TPN group remained in
nitrogen balance when undergoing TPN at the hospital. However, they lost substantial
body weight and body
nitrogen over 10 weeks when compared with the oral-intake group. This loss in body mass was mainly a result of the prolonged
anorexia that all the patients had after weekly termination of
chemotherapy. This study demonstrates that well-nourished patients can use intravenous nutrition even while receiving cytocidal and
cytostatic drug administration. However, intermittent periods of adequate nutrition in the hospital had only a marginal impact, since the positive effects of nutrition were offset by the pronounced
anorexia that occurred in all patients outside the hospital for a considerable time after
cytostatic treatment.