Enteral Vs Oral Nutrition in non-interrupted compliance with chemoradiotherapy in subjects with esophageal cancer

Abstract

Background: Esophageal cancer (EC) generates malnutrition, added to the adverse effects of chemoradiotherapy. It is important to avoid intratreatment interruptions to improve survival. The objective is to evaluate the effect of Enteral Nutrition (EN) Vs Oral Nutrition (ON) in compliance without interruptions of chemoradiotherapy in adults with esophageal cancer, in two centers of La Plata Argentina, during 2014-2019. Methods: Retrospective cohort study. 76 subjects participated, 34 with EN and 46 with ON. Independent variable: type of nutrition, dependent variable: compliance with chemoradiotherapy; potentially confusing variables: sex, age, comorbidities, risk factors, and cancer stages. The percentages of qualitative variables were compared through Chi2 and the T test for the quantitative ones. The RR (95% CI) was calculated by comparing the interruptions in both groups. A crude and adjusted RR analysis was performed, stratifying by sex and clinical variables. Results: 34 subjects had EN and 42 ON; mean age: 65.9 (SD +/-: 10.5) and 68.4 (SD +/-: 9.9) respectively. In both groups, most participants with interruptions were men, in advanced stages, with radical treatment and a diagnosis of carcinoma. In the EN group, 44.12% had interruptions, compared to 14.3% of ON (p <0.05). The group with EN interrupted a mean of 9.9 days (SD +/-: 5.9) and ON: 8.3 (SD +/-: 9.2) (p> 0.05). Conclusion: The group with EN presented more interruptions, therefore it is not recommended for use prophylactically, only if necessary. Clinical Relevancy Statement: In esophageal cancer chemoradiotherapy, nutritional counseling is important to determine the appropriate feeding route for each patient in order to avoid treatment interruptions, since for each day of delay, the local control rate, general survival and patient's prognosis decreases.