Enteral feeding methods for nutritional management in patients with head and neck cancers being treated with radiotherapy and/or chemotherapy

Nugent, Brenda; Lewis, Sian; O’Sullivan, Joe M.

doi:10.1002/14651858.cd007904.pub3

Cited by 124 publications

(119 citation statements)

References 42 publications

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“…They identified four systematic reviews (Langius et al, 2013c;Nugent, Lewis, & O'Sullivan, 2013;Orphanidou et al, 2011;Wang, Liu, Liu, Ye, & Huang, 2014a) and four sets of clinical practice guidelines (Canada 2009, UK 2011, Australia 2014and America 2014 and provided detailed critical appraisal of the evidence.…”

Section: Tube Feeding: Optimal Type and Timingmentioning

confidence: 99%

“…There is no international consensus for the optimal method of tube feeding (Nugent et al, 2013), and centres have adapted either a proactive or reactive approach. The majority of studies supporting prophylactic gastrostomy insertion have been undertaken in patients receiving treatment with conformal radiotherapy or radiotherapy alone (Lee et al, 1998;Senft, Fietkau, Iro, Sailer, & Sauer, 1993;Tyldesley et al, 1996).…”

Section: Appropriate Access To Nutrition Carementioning

confidence: 99%

“…The optimal form of tube feeding remains controversial in the literature, with inadequate high level evidence to enable any firm recommendations (Langius et al, 2013c;Nugent et al, 2013;Wang et al, 2014a). Risks of gastrostomy placement in the selection of feeding tube need to be considered (Grant et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

“…Extensive research supports nutritional intervention, specifically enteral nutrition, to help patients meet their nutritional requirements and mitigate these side effects (Brown et al, 2014a;Brown et al, 2013b;Isenring et al, 2004;Jeffery, Sherriff, & Langdon, 2012). Although the optimal form of nutrition support is yet to be identified (Moor et al, 2010;Nugent et al, 2013), proactive gastrostomy placement (insertion of a feeding gastrostomy tube prior to treatment) in anticipation of adverse outcomes that may lead to malnutrition, has gained popularity (Orphanidou et al, 2011). As previous observational studies (Locher et al, 2013;Strom et al, 2013) have identified, predicting the requirement for proactive gastrostomy placement is often complicated by confounding factors and selection bias.…”

Section: Introductionmentioning

confidence: 99%

“…The role of dietary counselling in improving nutrition outcomes for patients with head and neck cancer has been well documented (Garg et al, 2010;Langius et al, 2013c), but the optimal management with patients requiring enteral tube feeding remains unclear and so no firm recommendations can be made (Langius et al, 2013c;Nugent et al, 2013). The debate in the literature continues as to whether patients with head and neck cancer should have a nasogastric tube or gastrostomy tube (Corry et al, 2008;Wang et al, 2014a) and the optimal timing of gastrostomy placement (Bradley, Brown, & Paleri, 2015;Talwar & Findlay, 2012).…”

Section: Introductionmentioning

confidence: 99%

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Optimising nutrition support in patients with head and neck cancer

Brown¹

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Section: Tube Feeding: Optimal Type and Timingmentioning

confidence: 99%

Section: Appropriate Access To Nutrition Carementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Optimising nutrition support in patients with head and neck cancer

Brown¹

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Non–Cancer-Related Deaths From Suicide, Cardiovascular Disease, and Pneumonia in Patients With Oral Cavity and Oropharyngeal Squamous Carcinoma

Gao

Mehta

Branovan

et al. 2012

Arch Otolaryngol Head Neck Surg

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Suicide rates have significantly increased in patients with OC/OP cancer since 1980 to 1984. Although cardiovascular disease-and pneumonia-related deaths have significantly decreased over time, they remain higher than the general US population. Increased knowledge of risk factors associated with non-cancer-related mortality in OC/OP cancer may lead to early intervention and enhanced overall survival.

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A Model for Predicting Gastrostomy Tube Placement in Patients Undergoing Surgery for Upper Aerodigestive Tract Lesions

Mays

Moustafa

Worley

et al. 2014

JAMA Otolaryngol Head Neck Surg

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IMPORTANCE Identifying high-risk patients in the preoperative period can allow physicians to optimize nutritional status early for better outcomes after head and neck cancer resections. OBJECTIVE To develop a model to predict preoperatively the need for gastrostomy tube (G-tube) placement in patients undergoing surgery of the upper aerodigestive tract. DESIGN, SETTING, AND PARTICIPANTS This retrospective medical record review included all adult patients diagnosed with head and neck cancers who underwent tumor resection from 2007 through 2012 at Wake Forest Baptist Health, a level 1 tertiary care center. Records were screened for patient demographics, tumor characteristics, surgical treatment type, and postoperative placement of G-tube. A total of 743 patients underwent resection of head and neck tumors. Of these, 203 were excluded for prior G-tube placement, prior head and neck resection, G-tube placement for chemoradiotherapy, and resection for solely nodal disease, leaving 540 patients for analysis. MAIN OUTCOMES AND MEASURES Placement of postoperative G-tube. RESULTS Of the 540 included patients, 23% required G-tube placement. The following variables were significant and independent predictors of G-tube placement: preoperative irradiation (odds ratio [OR], 4.1; 95% CI, 2.4–6.9; P < .001), supracricoid laryngectomy (OR, 26.0; 95% CI, 4.9–142.9; P < .001), tracheostomy tube placement (OR, 2.6; 95% CI, 1.5–4.4; P < .001), clinical node stage N0 vs N2 (OR, 2.4; 95% CI, 1.4–4.2; P = .01), clinical node stage N1 vs N2 (OR, 1.6; 95% CI, 0.8–3.3; P = .01), preoperative weight loss (OR, 2.0; 95% CI, 1.2–3.2; P = .004), dysphagia (OR, 2.0; 95% CI, 1.2–3.2; P = .005), reconstruction type (OR, 1.9; 95% CI, 1.1–2.9; P = .02), and tumor stage (OR, 1.8; 95% CI, 1.1–2.9; P = .03). A predictive model was developed based on these variables. In the validation analysis, we found that the average predicted score for patients who received G-tubes was statistically different than the score for the patients who did not receive G-tubes (P = .01). CONCLUSIONS AND RELEVANCE We present a validated and comprehensive model for preoperatively predicting the need for G-tube placement in patients undergoing surgery of the upper aerodigestive tract. Early enteral access in high-risk patients may prevent complications in postoperative healing and improve overall outcomes, including quality of life.

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Enteral feeding methods for nutritional management in patients with head and neck cancers being treated with radiotherapy and/or chemotherapy

Abstract: Enteral feeding methods for nutritional management in patients with head and neck cancers being treated with radiotherapy and/or chemotherapy.

Cited by 124 publications

References 42 publications

Optimising nutrition support in patients with head and neck cancer

Optimising nutrition support in patients with head and neck cancer

Non–Cancer-Related Deaths From Suicide, Cardiovascular Disease, and Pneumonia in Patients With Oral Cavity and Oropharyngeal Squamous Carcinoma

A Model for Predicting Gastrostomy Tube Placement in Patients Undergoing Surgery for Upper Aerodigestive Tract Lesions

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