Impact of feeding tubes on prospective functional outcomes in patients with locally advanced head and neck cancer undergoing radiation therapy.

Abstract

PURPOSE:

The optimal timing of enteral feeding tube (FT) insertion during radiation therapy for head and neck cancer remains controversial. This study compares prospectively collected functional outcomes for prophylactic versus reactive insertion.

METHODS AND MATERIALS:

Patients undergoing primary radiation therapy for stage III-IV head and neck cancer between 2004 and 2009 underwent functional outcome assessment at baseline and 3, 6, 12, 24, and 36 months posttreatment. Instruments included the Royal Brisbane Hospital Outcome Measure for Swallowing, Performance Status Scale for Head and Neck Cancer Patients, and modified Edmonton Symptom Assessment Scale. Multivariable regression analysis was conducted to determine the impact of FT use on functional outcomes.

RESULTS:

A total of 178 patients were assessed with a median follow-up of 36.4 months. Use of an FT was prophylactic in 92 and reactive in 24; no tube was used in 62 patients. Compared with prophylactic placement, reactive FT use was not associated with worse function for Performance Status Scale for Head and Neck Cancer Patients Normalcy of Diet for soft foods (adjusted odds ratio [AOR] 1.16, P = .85) or Eating in Public (AOR 1.87, P = .31). Similarly, there were no differences in the Royal Brisbane Hospital Outcome Measure for Swallowing for modified diet (AOR 1.27, P = .7) or FT dependence (AOR 3.01, P = .2).

CONCLUSIONS:

There were no significant differences in long-term swallowing function between patients who received a prophylactic versus reactive FT.

• Authors: Harvey Quon, Candace Myers, Pascal Lambert, James Butler, Ahmed Abdoh, Ross Stimpson, Donald R Duerksen, Heather Campbell-Enns, Angela Martens
• Journal: Practical radiation oncology (Pract Radiat Oncol) 2015 Nov-Dec Vol. 5 Issue 6 Pg. e567-73 ISSN: 1879-8519 [Electronic] United States
• PMID: 26215583 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2015 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

Topics

• Deglutition
• Enteral Nutrition (instrumentation)
• Female
• Head and Neck Neoplasms (radiotherapy)
• Humans
• Intubation, Gastrointestinal
• Male
• Middle Aged
• Neoplasm Staging
• Prognosis
• Prospective Studies
• Radiotherapy, Intensity-Modulated
• Recovery of Function
• Retrospective Studies