Nasogastric tube feeding and percutaneous endoscopic gastrostomy tube feeding in patients with head and neck cancer

• Published in: Journal of human nutrition and dietetics 2010-06, Vol.23 (3), p.277-284
• Main Authors: Nugent, B, Parker, M.J, McIntyre, I.A
• Format: Article
• Language: English
• Subjects: Adult; Antineoplastic Agents - adverse effects; Biological and medical sciences; BMI; Combined Modality Therapy; endoscopy; enteral feeding; Enteral Nutrition - methods; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Gastroscopy; Gastrostomy; head and neck cancer; head and neck neoplasms; Head and Neck Neoplasms - complications; Head and Neck Neoplasms - drug therapy; Head and Neck Neoplasms - radiotherapy; Humans; Intubation, Gastrointestinal; Male; Malnutrition - etiology; Malnutrition - therapy; nasogastric tube feeding; neoplasms; nutrition assessment; nutritional status; patients; percutaneous endoscopic gastrostomy tube feeding; Radiotherapy - adverse effects; Retrospective Studies; transdermal application; tube feeding; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Weight Loss
• ISSN: 0952-3871; 1365-277X
• DOI: 10.1111/j.1365-277X.2010.01047.x

For patients with a diagnosis of head and neck cancer, oral nutrition may not provide adequate nutrition during radical radiotherapy or chemoradiation treatment, resulting in enteral feeding initiation. Enteral feeding may be delivered via a nasogastric tube or by a gastrostomy tube. The present study aimed to determine how different treatment modalities impact on requirement for enteral feeding and which method of enteral feeding provided the most benefit to the patient, as demonstrated by weight loss and the number of unscheduled radiotherapy treatment interruptions. Patients who were treated with radical radiotherapy or chemoradiation between January 2004 and June 2007 were reviewed retrospectively (n = 196, male = 149, female = 47). Data were collected on demographics, diagnosis, T and N classification, nutritional status, unscheduled radiotherapy treatment interruptions, and type and duration of enteral feeding. Subjects were divided into three subgroups depending on the treatment received. Comparisons were then made between methods of enteral feeding. Combined modality treatment (Induction Chemotherapy and Chemoradiation) results in a higher proportion of patients requiring enteral feeding (66-71% compared to 12% for radiotherapy). Patients fed via a prophylactic percutaneous endoscopic gastrostomy lost the least amount of weight during treatment (-4.6% to +1.4%), although the method of enteral feeding did not statistically influence weight difference at the end of treatment. The enteral feeding method did not influence unscheduled radiotherapy treatment interruptions. Combined modality treatment results in a greater requirement for enteral feeding, with these patient groups having the greatest weight loss. The findings obtained in the present study indicate that the method of enteral feeding did not statistically influence weight loss at the end of treatment or unscheduled radiotherapy treatment interruptions.