Impact of Current Smoking and Alcohol Consumption on Gastrostomy Duration in Patients With Head and Neck Cancer Undergoing Definitive Chemoradiotherapy

O’Shea, Ross; Byrne, Helen; Tuckett, Joel; O’Leary, Gerard; Sheahan, Patrick

doi:10.1001/jamaoto.2015.0279

Cited by 15 publications

(8 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…69 Smoking and alcohol use during and after radiation therapy have been associated with an increased risk of osteoradionecrosis of the jaw in patients with oral and oropharyngeal cancers. [70][71][72][73] Alcohol abuse also complicates treatment outcomes among patients with cancer by contributing to longer hospitalizations, increased surgical procedures, prolonged recovery, higher health care costs, [74][75][76] and higher mortality. 77 Heavy alcohol use and abuse are important modifiable risk factors for postoperative morbidity.…”

Section: Alcohol and Cancer: Outcomes And Effect On Treatmentmentioning

confidence: 99%

Alcohol and Cancer: A Statement of the American Society of Clinical Oncology

LoConte

Brewster²,

Kaur

et al. 2018

JCO

257

178

View full text Add to dashboard Cite

Alcohol drinking is an established risk factor for several malignancies, and it is a potentially modifiable risk factor for cancer. The Cancer Prevention Committee of the American Society of Clinical Oncology (ASCO) believes that a proactive stance by the Society to minimize excessive exposure to alcohol has important implications for cancer prevention. In addition, the role of alcohol drinking on outcomes in patients with cancer is in its formative stages, and ASCO can play a key role by generating a research agenda. Also, ASCO could provide needed leadership in the cancer community on this issue. In the issuance of this statement, ASCO joins a growing number of international organizations by establishing a platform to support effective public health strategies in this area. The goals of this statement are to: • Promote public education about the risks between alcohol abuse and certain types of cancer; • Support policy efforts to reduce the risk of cancer through evidence-based strategies that prevent excessive use of alcohol; • Provide education to oncology providers about the influence of excessive alcohol use and cancer risks and treatment complications, including clarification of conflicting evidence; and • Identify areas of needed research regarding the relationship between alcohol use and cancer risk and outcomes.

show abstract

Section: Alcohol and Cancer: Outcomes And Effect On Treatmentmentioning

confidence: 99%

Alcohol and Cancer: A Statement of the American Society of Clinical Oncology

LoConte

Brewster²,

Kaur

et al. 2018

JCO

257

178

View full text Add to dashboard Cite

show abstract

“…At 6 months, patients were also more likely to be PEG dependent if they smoked during treatment. The consequence of smoking on oxygenation of the tissues may impact negatively on muscle function leading to a higher likelihood of requiring enteral feeds for longer 19 . Smoking delays wound healing and thus may slow recovery from mucositis after radiotherapy 20 .…”

Section: Discussionmentioning

confidence: 99%

Gastrostomy dependency trends over 15 years of patients at a large tertiary referral center following the insertion of a prophylactic gastrostomy for chemoradiation for mucosal head and neck cancer

Fraser

Odelli

Britton

et al. 2020

Asia-Pac J Clncl Oncology

View full text Add to dashboard Cite

Aim: The routine use of prophylactic percutaneous endoscopic gastrostomy (PEG) tubes for nutrition support during radical chemoradiation for head and neck cancer has been suggested to result in PEG dependency. This research aimed to determine the rates of gastrostomy dependency at the Calvary Mater Newcastle (CMN) where PEGs are routinely used and to identify potentially modifiable risk factors. Methods: All patients with head and neck cancer planned for curative chemoradiation with a prophylactic PEG inserted were included in this review. Medical records of 250 patients treated between 2000 and 2015 were examined. Results: Overall, eight patients (3%) were unable to wean. At 12 months following treatment, 16 patients (6%) still required PEG tubes for feeding. A greater T extent (T4 or synchronous head and neck tumors) and number of days Nil By Mouth (NBM) remained as significant independent risk factors for PEG dependency at 12 months (Textent OR 6.96 P < .001; NBM OR 1.01 P = .004) and overall (Textent OR8.04 P = .02; NBM OR1.01 P = .001). Associations with NBM were investigated, which demonstrated that patients had less NBM days with intensity-modulated radiation therapy (IMRT) (-13.3, P = .007) and seeing a speech pathologist during treatment (-11.9, P = .026). More NBM days were associated with tumors with greater T extent (+22; P < .001). Conclusion: The routine use of prophylactic PEGs has not resulted in significant rates of PEG dependency at the CMN. Seeing a speech pathologist during treatment and IMRT may decrease time NBM, which was identified as a potentially modifiable risk factor for PEG dependency. K E Y W O R D S chemoradiotherapy, enteral nutrition, gastrostomy, head and neck cancer 1 INTRODUCTION Dehydration, malnutrition, and weight loss in head and neck (H+N) cancer patients undergoing chemoradiation can cause treatment interruptions and unplanned hospital admissions. 1 Mick et al identified weight loss as the strongest independent predictor of survival in patients with advanced stage H+N cancer undergoing multimodal therapy. 2 The side effects of chemoradiation for H+N cancer (mucosi-tis, xerostomia, dysguesia, dysphagia, odynophagia, nausea, and vomiting) make it difficult for patients to meet their nutrition requirements orally. 3 Enteral nutrition to supplement oral intake is frequently used; however, the route remains debatable. 4 Enteral nutrition approaches include a prophylactic percutaneous endoscopic gastrostomy (PEG) tube, reactive nasogastric tube (NGT), or reactive PEG placement. The use of prophylactic PEG tubes for chemoradiation has been extensively debated. 5 It has been theorized e198 c

show abstract

“…O'Shea et al [55] analyzed the impact of smoking and alcohol consumption on the duration of gastrostomy tube (GT) use and dependence rates. This retrospective study involved 104 HNC patients undergoing RT/CRT.…”

Section: Prophylactic Versus Reactive Feeding Tube In Hnc Patients Unmentioning

confidence: 99%

Nutritional Support in Head and Neck Radiotherapy Patients Considering HPV Status

et al. 2020

View full text Add to dashboard Cite

Malnutrition is a common problem in patients with head and neck cancer (HNC), including oropharyngeal cancer (OPC). It is caused by insufficient food intake due to dysphagia, odynophagia, and a lack of appetite caused by the tumor. It is also secondary to the oncological treatment of the basic disease, such as radiotherapy (RT) and chemoradiotherapy (CRT), as a consequence of mucositis with the dry mouth, loss of taste, and dysphagia. The severe dysphagia leads to a definitive total impossibility of eating through the mouth in 20–30% of patients. These patients usually require enteral nutritional support. Feeding tubes are a commonly used nutritional intervention during radiotherapy, most frequently percutaneous gastrostomy tube. Recently, a novel HPV-related type of OPC has been described. Patients with HPV-associated OPC are different from the HPV− ones. Typical HPV− OPC is associated with smoking and alcohol abuse. Patients with HPV+ OPC are younger and healthy (without comorbidities) at diagnosis compared to HPV− ones. Patients with OPC are at high nutritional risk, and therefore, they require nutritional support in order to improve the treatment results and quality of life. Some authors noted the high incidence of critical weight loss (CWL) in patients with HPV-related OPC. Other authors have observed the increased acute toxicities during oncological treatment in HPV+ OPC patients compared to HPV− ones. The aim of this paper is to review and discuss the indications for nutritional support and the kinds of nutrition, including immunonutrition (IN), in HNC, particularly OPC patients, undergoing RT/CRT, considering HPV status.

show abstract

Impact of Current Smoking and Alcohol Consumption on Gastrostomy Duration in Patients With Head and Neck Cancer Undergoing Definitive Chemoradiotherapy

Cited by 15 publications

References 25 publications

Alcohol and Cancer: A Statement of the American Society of Clinical Oncology

Alcohol and Cancer: A Statement of the American Society of Clinical Oncology

Gastrostomy dependency trends over 15 years of patients at a large tertiary referral center following the insertion of a prophylactic gastrostomy for chemoradiation for mucosal head and neck cancer

Nutritional Support in Head and Neck Radiotherapy Patients Considering HPV Status

Contact Info

Product

Resources

About