Safety and effectiveness of prophylactic gastrostomy tubes for head and neck cancer patients undergoing chemoradiation
| Autor: | Howard Lee, Ly M. Nguyen, C. Lemanski, Debra North, Sabah Sallah, Suresh Dutta, Ulf Karlsson, Tomas M. Martinez, Herbert J. Smith, Nam P. Nguyen, Alan A. Alfieri, Adir Ludin |
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| Rok vydání: | 2006 |
| Předmět: |
Adult
Male Mucositis medicine.medical_specialty medicine.medical_treatment Aspiration pneumonia Enteral Nutrition Weight loss Risk Factors Percutaneous endoscopic gastrostomy Weight Loss medicine Prevalence Humans Prospective Studies Prospective cohort study Aged Aged 80 and over Gastrostomy Chemotherapy business.industry Head and neck cancer Middle Aged medicine.disease Dysphagia Combined Modality Therapy Surgery Oncology Head and Neck Neoplasms Female medicine.symptom business Deglutition Disorders |
| Zdroj: | Surgical oncology. 15(4) |
| ISSN: | 0960-7404 |
| Popis: | Summary Background We would like to assess the safety and effectiveness of prophylactic percutaneous endoscopic gastrostomy (PEG) tube feedings during concurrent chemoradiation for head and neck cancer. Methods Patients who underwent chemotherapy and radiation for head and neck malignancies were evaluated for their ability to resume oral feeding following treatment. All patients underwent PEG tube placement prior to the treatment because of the expected mucositis. Gastrostomy tubes were removed following treatment when the patients were able to resume oral feedings without aspiration. Results Between March 1999 and 2006, 104 patients with locally advanced head and neck cancer underwent concurrent chemotherapy and radiation. One patient declined placement of gastrostomy tube. Ninety patients (86%) developed grade 3–4 mucositis during chemoradiation. Five patients died during treatment from aspiration pneumonia and sepsis. One hundred two patients lost weight during treatment. The mean and median weight loss during concurrent therapy was, respectively, 8.5 and 8 kg (1–23.5 kg). Following treatment, tube feedings were continued 1–41 months (mean: 8 months; median: 5 months) because of continued weight loss, chronic dysphagia, or aspiration. At a median follow-up of 19 months (1–62 months), no patient developed serious complications from tube feedings. Conclusion Dysphagia resulting from the severe mucositis produced severe weight loss, despite tube feedings. Gastrostomy tube feedings are safe. Gastrostomy tubes should be placed prophylactically for patients undergoing chemoradiation for head and neck cancer. |
| Databáze: | OpenAIRE |
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