Predictors of Gastrostomy Tube Placement in Head and Neck Cancer Patients Undergoing Radiation or Chemoradiotherapy: A Systematic Review.

IF 2.3 3区医学 Q1 OTORHINOLARYNGOLOGY Head and Neck-Journal for the Sciences and Specialties of the Head and Neck Pub Date : 2024-11-25 DOI:10.1002/hed.28010

Jenny B Xiao, Abhiram Cherukupalli, Khanh Linh Tran, Eitan Prisman

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Abstract

Background: Malnutrition is a major problem in head and neck cancer (HNC) with up to half of patients requiring gastrostomy tube (G-tube) placement. Predicting this need remains complex given mixed evidence surrounding its usage.

Methods: A comprehensive search was performed to identify studies examining risk factors associated with G-tube placement following radiotherapy (RT) or concurrent chemoradiotherapy (CCRT) in HNC patients.

Results: Sixteen retrospective studies were included (n = 11 015). The overall prevalence of G-tube placement was 44% with 76% of patients receiving reactive G-tube placement. Pretreatment dysphagia, pretreatment BMI < 18.5, and tumors in the hypopharynx were significant predictive factors for prophylactic G-tube placement. Type of chemotherapy regimen, tumors in the nasopharynx, and cytokine changes were significant predictive factors for reactive G-tube placement.

Conclusion: Several factors were identified that contribute to increased risk of G-tube placement and may guide current decision-making algorithms.

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接受放疗或化疗的头颈部癌症患者放置胃管的预测因素：系统回顾

背景：营养不良是头颈癌（HNC）的一个主要问题，多达一半的患者需要放置胃造瘘管（G 管）。由于有关胃管使用的证据不一，因此预测这种需求仍然很复杂：方法：我们进行了一次全面检索，以确定与HNC患者放疗（RT）或同期化放疗（CCRT）后放置胃管相关的风险因素的研究：结果：共纳入16项回顾性研究（n = 11 015）。总的 G 管置入率为 44%，76% 的患者接受反应性 G 管置入。治疗前吞咽困难、治疗前体重指数结论：研究发现了导致 G 管置入风险增加的几个因素，可为当前的决策算法提供指导。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck 医学-耳鼻喉科学

CiteScore

7.00

自引率

6.90%

发文量

278

审稿时长

1.6 months

期刊介绍： Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.