Tube feeding in patients with head and neck cancer undergoing chemoradiotherapy: A systematic review

Bossola, Maurizio; Antocicco, Manuela; Pepe, Gilda

doi:10.1002/jpen.2360

Cited by 17 publications

(4 citation statements)

References 42 publications

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“…However, complications such as increased tube dislodgement and chest infection were noticed after a long period in patients with NGTs. Additionally, compared to patients with gastrostomies, patients with nasogastric tubes reported greater body image problems, difficulty with feeding, and considerable social activity interruption [57,58].…”

Section: Nasogastric Tubementioning

confidence: 99%

Nutritional Management of Patients with Head and Neck Cancer—A Comprehensive Review

et al. 2023

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While surgical therapy for head and neck cancer (HNC) is showing improvement with the advancement of reconstruction techniques, the focus in these patients should also be shifting to supportive pre and aftercare. Due to the highly sensitive and anatomically complex region, these patients tend to exhibit malnutrition, which has a substantial impact on their recovery and quality of life. The complications and symptoms of both the disease and the therapy usually make these patients unable to orally intake food, hence, a strategy should be prepared for their nutritional management. Even though there are several possible nutritional modalities that can be administrated, these patients commonly have a functional gastrointestinal tract, and enteral nutrition is indicated over the parenteral option. However, after extensive research of the available literature, it seems that there is a limited number of studies that focus on this important issue. Furthermore, there are no recommendations or guidelines regarding the nutritional management of HNC patients, pre- or post-operatively. Henceforth, this narrative review summarizes the nutritional challenges and management modalities in this particular group of patients. Nonetheless, this issue should be addressed in future studies and an algorithm should be established for better nutritional care of these patients.

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Section: Nasogastric Tubementioning

confidence: 99%

Nutritional Management of Patients with Head and Neck Cancer—A Comprehensive Review

et al. 2023

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“…After reviewing 26 manuscripts, Bossola et al. concluded that the use of nasogastric (NGT) and PEG tubes was comparable regarding nutritional and oncologic endpoints [ 13 ]. On the one hand, PEG tube placement is known for its potential minor (e.g., peristomal leaks, infection) or major complications (e.g., bowel perforation, gastrointestinal hemorrhage, or even procedure-related mortality) [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

“…On the one hand, PEG tube placement is known for its potential minor (e.g., peristomal leaks, infection) or major complications (e.g., bowel perforation, gastrointestinal hemorrhage, or even procedure-related mortality) [ 14 ]. On the other hand, NGT dislocate more frequently, cause more patient discomfort, and promote aspiration pneumonia [ 13 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Multidisciplinary survey on use of feeding tubes in head and neck cancer patients undergoing chemoradiotherapy in Germany—the SUFEETUBE project

Löser,

Fabian,

Rühle

et al. 2024

Strahlenther Onkol

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Background and objective Data on enteral tube feeding in head and neck cancer (HNC) patients undergoing chemoradiotherapy vary considerably between German institutions. This survey aims to investigate the management of feeding tubes in an interdisciplinary context across Germany. Materials and methods Between December 2022 and May 2023, 70 participants (42 radiation oncologists, 12 medical oncologists, 14 head and neck surgeons, and 2 physicians covering several specialties) responded to our web-based survey. In addition to the type of institution (university hospital, private practice, etc.), their age, and professional experience (in years), participants were asked several questions on the indication and institutional policy for tube placement and management (prophylactic/reactive nasogastric or gastrostomy tube). All questions were mandatory single- or multiple-choice questions, while additional comments were possible by email. Results Most participants were employed at a university hospital (n = 52; 74.3%) and came from a radiation oncology background (n = 42; 60%). Fifty-four contributors (77.1%) reported that no nutritional risk screening prior to chemoradiotherapy was routinely performed, and 71.4% (n = 50) stated that no standardized protocol was used at the institution to set the indication for tube placement. Generally, policies and methods of tube feeding vary considerably between the individual institutions and specialties. However, the majority (n = 56, 80%) recommended a prophylactic percutaneous enteral gastrostomy (PEG) tube to their patients before chemoradiotherapy. Still, there was no consistent trend regarding the approach for reactive tube feeding. Conclusion The policies and methods of tube feeding vary considerably between the individual institutions and specialties in Germany. In the era of individualized medicine, uniform protocols are difficult to establish. However, a baseline nutritional risk screening could simplify decision-making in clinical practice.

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“…Although reliable enteral access via FT has improved outcomes for patients, [5][6][7] the impact of complications from the feeding tube on a patient's nutritional status is not well known. Minor feeding tube complications are reported in 13% to 40% of patients, while serious complications (peritonitis, necrotizing abdominal wall infection, gastric bleeding, injury to internal organs, tumor seeding at feeding tube site, and death) occur in 0.4% to 4.4% of patients.…”

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confidence: 99%

Feeding Tube Clinic Effect on Nutrition

Choy,

Abbitt,

Moyer

et al. 2024

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Background: Optimizing nutrition is essential for recovery after major surgery or severe illness. Feeding tubes (FT) can be placed in patients limited by oral enteral nutrition. Given the myriad of locations in which these procedures are performed (radiology, intensive care unit, and endoscopy suite), routine follow-up is challenging. The purpose of this study was to evaluate the impact of an FT clinic on nutrition. We hypothesized that enrollment in the FT clinic would result in improved nutritional outcomes. Methods: Retrospective review of Veteran Affairs Medical Center patients with FTs placed from January 2010 to January 2020. Demographics and body mass index (BMI) were recorded. Serum albumin recorded within 1 month of tube placement was compared to within 1 month of tube removal, death, or at the end of the study period. FT clinic participation required at least 2 visits. Indications for FT placement and duration were recorded. Patients were excluded when both BMI and albumin values were incomplete, and if FTs were placed for decompression. Results: Ninety-three patients underwent FT placement during the study period; 5 (5%) were excluded. The average age was 64.8±9.7 years, with the majority being male, 85 patients (97%). Eighteen (20%) patients were seen in the FT clinic (FTC) and 70 (80%) were managed outside of FTC (nFTC). There were no differences in age, gender, or indication for FT. Mean albumin increased 0.42±0.85 g/dL in the FTC group versus −0.07±0.72 g/dL in the nFTC group (P=0.037). The FTC group BMI increased, 0.38 kg/m2 vs. −1.48 kg/m2 in nFTC patients, P=0.041. The FTC patients maintained their tubes longer (36.5 vs. 7.0 mo, P=0.0014). Conclusions: Patients managed in a dedicated FT clinic experienced an improvement in their serum albumin values and increases in their BMI. In addition, they also maintained their FTs longer. To optimize nutrition and reduce weight loss, patients who require FTs should be enrolled in a dedicated FT clinic.

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Tube feeding in patients with head and neck cancer undergoing chemoradiotherapy: A systematic review

Cited by 17 publications

References 42 publications

Nutritional Management of Patients with Head and Neck Cancer—A Comprehensive Review

Nutritional Management of Patients with Head and Neck Cancer—A Comprehensive Review

Multidisciplinary survey on use of feeding tubes in head and neck cancer patients undergoing chemoradiotherapy in Germany—the SUFEETUBE project

Feeding Tube Clinic Effect on Nutrition

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