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Lookup NU author(s): Professor Vinidh Paleri,
Dr Joanne Patterson
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Objectives: To perform a systematic review of studies, which investigate the role of gastrostomy tube feeding in head and neck squamous cell cancer. Design: A systematic review of the English literature, identifying areas of clinical equipoise and recommendations for future studies. Main outcome measures: Varying practices in G-tube use in HNSCC, the benefits and disadvantages of G-tubes, the effect of G-tube placement on multidimensional outcomes in patients with head and neck cancer, including quality of life and health economics and to draw themes that may lend themselves to future research. Results: The search identified 216 articles of which 59 were considered relevant. During treatment, a significant number of patients need enteral nutritional supplementation through nasogastric or G-tubes. Gastrostomy tubes have a good safety profile. Most clinicians agree that the use should be restricted to advanced tumours. Studies on prophylactic insertion of G-tubes do not show a consistent advantage to the nutritional status compared with NG tubes. At 1 year, G-tube retention rates vary between 10% and 30%. The presence of a feeding tube has a negative impact on quality of life. Placing G-tubes may have an adverse effect on swallowing after chemoradiation. Conclusions: There is a lack of consensus among clinicians about indications for placing G-tubes. There is sufficient equipoise in this area for further investigation of the effect of varying feeding practices on functional outcomes, quality of life and health economics.
Author(s): Paleri V, Patterson J
Publication type: Review
Publication status: Published
Journal: Clinical Otolaryngology
Print publication date: 19/04/2010
ISSN (print): 1749-4478
ISSN (electronic): 1749-4486
Publisher: WILEY-BLACKWELL PUBLISHING, INC