Nasogastric and percutaneous endoscopic gastrostomy feeding in head and neck cancer patients receiving radiotherapy treatment at a regional oncology unit: a two year study.

Abstract

The aim of this prospective two year study was to compare the outcome of two methods of nutritional support, namely nasogastric [NG] and percutaneous endoscopic gastrostomy [PEG] feeding implemented for head and neck cancer patients unable to maintain their nutritional status whilst receiving radiotherapy treatment at a regional oncology unit. The nutritional requirements of the 100 patients included in the study were calculated and an enteral feeding regime implemented to ensure the nutritional requirements of each individual patient were met. Any changes in the weight and body mass index [BMI] of each patient during the study period were documented. The method of delivery, composition of feed and duration of nutritional support of each feeding method were determined. The feeding methods were found to be equally effective at maintaining body weight. Patients with NG tubes in situ were more frequently prescribed a standard 1 kcal/ml feed administered via an enteral feeding pump, whereas patients with PEG tubes in situ were more frequently prescribed a high energy 1.5 Kcal/ ml feed administered by the bolus method. A number of advantages are associated with PEG feeding including greater mobility, cosmesis and quality of life. Evidence indicates the outcome of radiotherapy treatment is not as favourable if interrupted, therefore, it is essential PEG tubes are sited prior to commencing treatment, illustrating the necessity for dietetic intervention for every patient to be addressed and incorporated into the treatment plan on diagnosis of head and neck cancer before definitive management commences.