| Summary: | For many patients with advanced stages of head and / or neck (HN) cancer, oral nutrition does not provide enough nourishment during treatment with chemoradiotherapy (CT) and / or radiotherapy (RT) due to the acute toxicity of treatment, obstruction caused by the tumour, or both. It has been reported that these patients are more likely to experience nutritional depletion than patients with any other cancer during all illness phases. Many patients enter treatment with weight loss and up to 80% lose additional weight during treatment; poor nutrition is linked with poor prognoses. In these cases, enteral nutrition (i.e., delivered straight to the intestine) is considered the best option. Non-oral / enteral supply of nutrients can be delivered directly into the stomach via a nasogastric (NG) feeding tube inserted through the nose into the stomach, or via a percutaneous endoscopic gastrostomy (PEG) inserted through the skin of the abdomen directly into the stomach. The latter can be inserted prophylactically before treatment starts or reactively when the patient needs it. The optimal method of non-oral feeding is controversial. Although several groups have developed predictive models to determine which patients will benefit from feeding tubes and when, others believe the situation is too complex and multifactorial to make this type of tool usable. The purpose of this report is to assess the literature reporting on NG feeding tubes versus PEG for this patient group, including the guidance contained in relevant evidence-based CPGs
|
|---|