Predictors of Gastrostomy Tube Placement in Head and Neck Cancer Patients Undergoing Radiation or Chemoradiotherapy: A Systematic Review

Abstract

BackgroundMalnutrition is a major problem in head and neck cancer (HNC) with up to half of patients requiring gastrostomy tube (G‐tube) placement. Predicting this need remains complex given mixed evidence surrounding its usage.MethodsA comprehensive search was performed to identify studies examining risk factors associated with G‐tube placement following radiotherapy (RT) or concurrent chemoradiotherapy (CCRT) in HNC patients.ResultsSixteen retrospective studies were included (n = 11 015). The overall prevalence of G‐tube placement was 44% with 76% of patients receiving reactive G‐tube placement. Pretreatment dysphagia, pretreatment BMI < 18.5, and tumors in the hypopharynx were significant predictive factors for prophylactic G‐tube placement. Type of chemotherapy regimen, tumors in the nasopharynx, and cytokine changes were significant predictive factors for reactive G‐tube placement.ConclusionSeveral factors were identified that contribute to increased risk of G‐tube placement and may guide current decision‐making algorithms.