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Cited by 113Clinical Nutrition and GastroenterologyHead and Neck Cancer StudiesDysphagia Assessment and Management

Percutaneous endoscopic gastrostomy versus nasogastric tube feeding for patients with head and neck cancer: a systematic review

Open access
Wang, J., Liu, M., Liu, C., Ye, Y., Huang, G.·2014·Journal of Radiation Research
DOI 10.1093/jrr/rrt144PMC PMC4014167
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Abstract

There are two main enteral feeding strategies-namely nasogastric (NG) tube feeding and percutaneous gastrostomy-used to improve the nutritional status of patients with head and neck cancer (HNC). But up till now there has been no consistent evidence about which method of enteral feeding is the optimal method for this patient group. To compare the effectiveness of percutaneous gastrostomy and NGT feeding in patients with HNC, relevant literature was identified through Medline, Embase, Pubmed, Cochrane, Wiley and manual searches. We included randomized controlled trials (RCTs) and non-experimental studies comparing percutaneous gastrostomy-including percutaneous endoscopic gastrostomy (PEG) and percutaneous fluoroscopic gastrostomy (PFG) -with NG for HNC patients. Data extraction recorded characteristics of intervention, type of study and factors that contributed to the methodological quality of the individual studies. Data were then compared with respect to nutritional status, duration of feeding, complications, radiotherapy delays, disease-free survival and overall survival. Methodological quality of RCTs and non-experimental studies were assessed with separate standard grading scales. It became apparent from our studies that both feeding strategies have advantages and disadvantages.

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Crossref · 10.1093/jrr/rrt144

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  • In that RCT, early recovery of intestinal function and improvement of quality of life were the main advantages.

    “Early 1603 recovery of intestinal function and an improvement of quality of life were the main advantages 1604 [215].”

    From ESPEN guideline on hospital nutrition (2021) · cites this paper as [215]

    The Results section (page unavailable) reports better global quality of life for some patients receiving percutaneous gastrostomy than for those receiving nasogastric feeding. Our copy does not report early recovery of intestinal function as an advantage, and the cited paper is a systematic review, not itself an RCT. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • In a single-center RCT of 280 esophagectomy patients, liquids on day one, soft solid foods on day two, and normal hospital food as tolerated were safe and feasible.

    “In a 1601 single-center RCT of 280 esophagectomy patients, liquids on day one, soft solid foods on day 1602 two, and normal hospital food as tolerated were shown to be a safe and feasible strategy.”

    From ESPEN guideline on hospital nutrition (2021) · cites this paper as [215]

    The Introduction and Results discuss tube feeding in patients with head and neck cancer, not oral feeding after esophagectomy. Searches for the 280-patient RCT and the day-one liquids/day-two soft-food schedule found no passage addressing the claim in our copy. (LLM, conf=0.76)

    Experimental — accuracy not yet measured

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Cites

No references could be resolved yet.

Research works printed but not linked: 23

  1. [1]Locher JL Bonner JA Carroll WR Prophylactic percutaneous endoscopic gastrostomy tube placement in treatment of head and neck cancer: a comprehensive review and call for evidence-based medicine J Parenter Enteral Nutr 2011 35 365 74 21527598
  2. [2]Vissink A Jansma J Spijkervet F Oral sequelae of head and neck radiotherapy Crit Rev Oral Biol Med 2003 14 199 212 12799323
  3. [3]Beer KT Krause KB Zuercher T Early percutaneous endoscopic gastrostomy insertion maintains nutritional state in patients with aerodigestive tract cancer Nutr Cancer 2005 52 29 34 16091001
  4. [4]Isenring EA Capra S Bauer JD Nutrition intervention is beneficial in oncology outpatients receiving radiotherapy to the gastrointestinal or head and neck area Br J Cancer 2004 91 447 52 15226773 PMC2409852
  5. [5]Mercuri A Joon DL Wada M The effect of an intensive nutritional program on daily set‐up variations and radiotherapy planning margins of head and neck cancer patients J Med Imaging Radiat Oncol 2009 53 500 5 19788487
  6. [6]Chao KS Deasy JO Markman J A prospective study of salivary function sparing in patients with head-and-neck cancers receiving intensity-modulated or three-dimensional radiation therapy: initial results Int J Radiat Oncol Biol Phys 2001 49 907 16 11240231
  7. [7]Kondrup J Rasmussen HH Hamberg O Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials Clin Nutr 2003 22 321 36 12765673
  8. [8]Nugent B Lewis S O'Sullivan JM Enteral feeding methods for nutritional management in patients with head and neck cancers being treated with radiotherapy and/or chemotherapy Cochrane Database Syst Rev 31 January 2013 10.1002/14651858.CD007904.pub3 PMC6769131 23440820 · DOI
  9. [9]Tucker AT Gourin CG Ghegan MD ‘Push'versus ‘pull'percutaneous endoscopic gastrostomy tube placement in patients with advanced head and neck cancer Laryngoscope 2003 113 1898 902 14603043
  10. [10]Sadasivan A Faizal B Kumar M Nasogastric and percutaneous endoscopic gastrostomy tube use in advanced head and neck cancer patients: a comparative study J Pain Palliat Care Pharmacother 2012 26 226 32 22973911
  11. [11]Nugent B Parker MJ McIntyre IA Nasogastric tube feeding and percutaneous endoscopic gastrostomy tube feeding in patients with head and neck cancer J Hum Nutr Diet 2010 23 277 84 20337841
  12. [12]Williams GF Teo MT Sen M Prestwich RJ. Enteral feeding outcomes after chemoradiotherapy for oropharynx cancer: a role for a prophylactic gastrostomy? Oral Oncol 2012 48 434 40 22209648
  13. [13]Corry J Poon W McPhee N Prospective study of percutaneous endoscopic gastrostomy tubes versus nasogastric tubes for enteral feeding in patients with head and neck cancer undergoing (chemo) radiation Head Neck 2009 31 867 76 19296528
  14. [14]Lees J Nasogastric and percutaneous endoscopic gastrostomy feeding in head and neck cancer patients receiving radiotherapy treatment at a regional oncology unit: a two year study Eur J Cancer Care (Engl) 1997 6 45 9 9238929
  15. [15]Magné N Marcy P Foa C Comparison between nasogastric tube feeding and percutaneous fluoroscopic gastrostomy in advanced head and neck cancer patients Eur Arch Otorhinolar-yngol 2001 258 89 92 11307612
  16. [16]Mekhail TM Adelstein DJ Rybicki LA Enteral nutrition during the treatment of head and neck carcinoma Cancer 2001 91 1785 90 11335904
  17. [17]Sobani ZA Ghaffar S Ahmed BN Comparison of outcomes of enteral feeding via nasogastric versus gastrostomy tubes in post operative patients with a principle diagnosis of squamous cell carcinoma of the oral cavity J Pak Med Assoc 2011 61 1042 5 22356051
  18. [18]Gomes C Jr Lustosa S Matos D (10 November 2010) Percutaneous endoscopic gastrostomy versus nasogastric tube feeding for adults with swallowing disturbances Cochrane Database Syst Rev 2010 11 0.1002/14651858.CD008096.pub2 21069702
  19. [19]Beavan J Conroy S Leonardi-Bee J Is looped nasogastric tube feeding more effective than conventional nasogastric tube feeding for dysphagia in acute stroke? Trials 2007 8 19 17683555 PMC1976319
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Cited by

Sorted by citations

Authors
Wang, J., Liu, M., Liu, C., Ye, Y., & Huang, G.
Affiliations
  • Bengbu Medical College (CN)
  • Nantong University (CN)
Corresponding author
Huang, G.
ORCID
Venue
Journal of Radiation Research
Publisher
Oxford University Press (OUP)
Published
2014-01-22
Volume
55
Issue
3
Pages
559-567
ISSN
  • 0449-3060 (ISSN-L)
  • 1349-9157
DOI
10.1093/jrr/rrt144
PMC
PMC4014167
OpenAlex
W2159300872
Cited by
113
References
0
Citations by year
2026: 9 · 2025: 6 · 2024: 6 · 2023: 10 · 2022: 4 · 2021: 14 · 2020: 8 · 2019: 10 · 2018: 7 · 2017: 6 · 2016: 13 · 2015: 16 · 2014: 4
FWCI
1.49
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Journal of Radiation Research (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
  • Health Sciences › Medicine › Otorhinolaryngology › Head and Neck Cancer Studies
  • Health Sciences › Health Professions › Speech and Hearing › Dysphagia Assessment and Management
Keywords
percutaneous endoscopic gastrostomy, nasogastric tube feeding, head and neck cancer, enteral nutrition, nutritional status, feeding complications, radiotherapy delay, disease-free survival, overall survival
MeSH terms
Enteral Nutrition, Female, Gastroscopy, Gastrostomy, Head and Neck Neoplasms, Humans, Intubation, Gastrointestinal, Male, Risk Factors, Comorbidity, Causality, Survival Rate, Treatment Outcome, Malnutrition

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