Beijer, S., Hupperets, P. S., van den Borne, B. E., Wijckmans, N. E., Spreeuwenberg, C., van den Brandt, P. A., & Dagnelie, P. C. (2010). Randomized clinical trial on the effects of adenosine 5'-triphosphate infusions on quality of life, functional status, and fatigue in preterminal cancer patients. Journal of Pain and Symptom Management, 40, 520–530.

To investigate the effects of adenosine 5'-triphosphate (ATP) infusions on quality-of-life (QOL) parameters in patients with preterminal cancers of mixed tumor types.

Patients were randomized to the usual care control group with standard nutritional advice or to the intervention of usual care, nutritional advice, and ATP infusion. An eight- to 10-hour ATP infusion was given weekly, with a maximum dose of 50 µ/kg/minute.

• In total, 83 patients (23 women, 60 men) (ATP, n = 44; control, n = 39) were included.
• Age ranged from 54 to 78 years.
• Patients were undergoing curative treatment for lung, colon, gastrointestinal, prostate, and other types of cancer.
• Patients reported fatigue and had weight loss greater than 5% or anorexia.

• The study was conducted at multiple sites in The Netherlands.
• The initial dose was given at the daycare centers of participating hospitals and then patients were infused at home.

The study was a randomized, controlled trial.

• Quality of Life Questionnaire
• Groningen Activity Restriction Scale (GARS)
• Dutch Short Fatigue Questionnaire
• Jamar Hydraulic Hand Dynamometer
• MicroFET 2 Dynamometer

• Between the ATP and control groups, no statistically significant differences were observed in QOL, functional status, or fatigue.
• Elbow flexor muscle strength had an almost significant increase in the control group (1.98).

Better survival was observed during the eight-week intervention in the ATP group. The rationale was that palliative cancer drugs cause serious side effects. The authors concluded that that may be an advantage of the ATP treatment.

• The study had a small sample size, with less than 100 patients.
• The increased drop-out may have limited the power of the study.
• Large heterogeneity existed between patients.
• The eight-week intervention was shorter than other studies of 12 weeks.

The study provided little useful information for nurses.