Appropriate guidelines for the use of TPN in cancer patients include:

d. Patients in whom treatment toxicity precludes the use of enteral nutrition

As a general rule, the most important factor to consider when making decisions about the use of TPN in patients with cancer is the response of the tumor to antineoplastic therapy. Appropriate guidelines would include the following: Short-term TPN is indicated in severely malnourished patients or in those in whom gastrointestinal or other toxicities preclude adequate enteral intake for seven days or a longer period. TPN is not indicated in well nourished or mildly malnourished patients undergoing therapy or surgery who would be expected to be able to resume adequate nutrition in approximately seven days. Long-term TPN is indicated in patients in whom treatment associated toxicities preclude the use of enteral nutrition and represent the primary impediment to the restoration of performance status. These patients should be expected to be responding to anti-tumor therapy. Long-term TPN is not indicated with rapidly progressive tumor growth which is unresponsive to such therapy.