Indicators for Enteral Nutrition Use and Prophylactic Percutaneous Endoscopic Gastrostomy Placement in Patients with Head and Neck Cancer Undergoing Chemoradiotherapy
| Autor: | Remco de Bree, Hester van Cruijsen, Chris H.J. Terhaard, Annemieke Kok, Nicole M. de Roos, Marja J. Leermakers-Vermeer, Nina C. van der Linden |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Nutrition and Disease medicine.medical_treatment PEG tube Medicine (miscellaneous) nutritional support Enteral administration chemoradiotherapy 03 medical and health sciences 0302 clinical medicine Risk Factors Percutaneous endoscopic gastrostomy Voeding en Ziekte PEG ratio medicine Journal Article Humans enteral nutrition Risk factor 030223 otorhinolaryngology Life Style Aged Retrospective Studies Nutrition and Dietetics business.industry Head and neck cancer Malnutrition Middle Aged medicine.disease Gastrostomy Surgery Parenteral nutrition Head and Neck Neoplasms 030220 oncology & carcinogenesis Multivariate Analysis gastrostomy Female head and neck cancer business Chemoradiotherapy Follow-Up Studies |
| Zdroj: | Nutrition in Clinical Practice, 32(2), 225-232 Nutrition in Clinical Practice, 32(2), 225. SAGE Publications Ltd Nutrition in Clinical Practice 32 (2017) 2 |
| ISSN: | 0884-5336 |
| Popis: | BACKGROUND: Chemoradiotherapy (CRT) is a major risk factor for malnutrition and dehydration in patients with head and neck cancer. Enteral support is often needed, and a percutaneous endoscopic gastrostomy (PEG) is frequently placed. Specific indicators for PEG placement remain unclear. This study retrospectively determined which factors contributed to enteral nutrition (EN) use and PEG placement in a large patient group to gain insight on potential indicators for PEG placement protocol creation. METHODS: A retrospective chart review of 240 patients with head and neck cancer who underwent CRT in 2012-2015 was conducted. Lifestyle, oncological, treatment, and nutrition outcome characteristics were examined and compared between patients who used EN and those who did not, as well as between patients who received a PEG and those who did not. RESULTS: In total, 195 patients used EN (via PEG or nasogastric tube). Multivariate analysis showed that nodal disease presence ( P = .01) and bilateral neck irradiation ( P = .01) were significantly related to EN use while increased age ( P = .01), nodal disease presence ( P = .02), reconstruction extent other than primary closure ( P = .02), bilateral neck irradiation ( P < .01), and an adapted intake consistency prior to treatment ( P = .03) were significantly related to PEG placement. CONCLUSION: Important factors for EN usage and PEG placement consideration include nodal disease and planned bilateral neck irradiation. Results from this study in combination with existing literature can be taken into consideration in the design of a PEG placement protocol. A better understanding of predictive indicators to PEG placement should be explored in further prospective studies. |
| Databáze: | OpenAIRE |
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