The Newcastle upon Tyne Foundation Hospitals NHS Trust, Newcastle Upon Tyne, UK.
Clin Otolaryngol. 2010 Jun;35(3):177-89. doi: 10.1111/j.1749-4486.2010.02128.x.
To perform a systematic review of studies, which investigate the role of gastrostomy tube feeding in head and neck squamous cell cancer.
A systematic review of the English literature, identifying areas of clinical equipoise and recommendations for future studies.
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.
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.
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.
系统回顾研究，调查胃造口管喂养在头颈部鳞状细胞癌中的作用。
对英文文献进行系统回顾，确定临床均势领域并为未来研究提出建议。
头颈部鳞状细胞癌患者胃管使用的不同实践、胃管的优缺点、胃管放置对头颈部癌症患者多维结局（包括生活质量和健康经济学）的影响，并总结可能有助于未来研究的主题。
搜索确定了 216 篇文章，其中 59 篇被认为是相关的。在治疗期间，相当数量的患者需要通过鼻胃管或胃管进行肠内营养补充。胃造口管具有良好的安全性。大多数临床医生认为，使用应限于晚期肿瘤。预防性插入胃管的研究并没有显示与 NG 管相比在营养状况方面有一致的优势。在 1 年时，胃管保留率在 10%至 30%之间变化。喂养管的存在对生活质量有负面影响。放置胃管可能对放化疗后吞咽功能产生不利影响。
临床医生对头颈癌患者胃管放置的适应证缺乏共识。在这一领域存在足够的临床均势，需要进一步研究不同喂养方式对功能结局、生活质量和健康经济学的影响。
