Kano Satoshi, Tsushima Nayuta, Suzuki Takayoshi, Hamada Seijiro, Yokokawa Taizo, Idogawa Hiroshi, Yasuda Koichi, Minatogawa Hideki, Dekura Yasuhiro, Aoyama Hidefumi, Homma Akihiro
Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
Department of Radiation Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
Int J Clin Oncol. 2021 Jul;26(7):1179-1187. doi: 10.1007/s10147-021-01889-w. Epub 2021 Jun 4.
We investigated whether prophylactic percutaneous endoscopic gastrostomy (PEG) is used effectively for patients treated with definitive concurrent chemoradiotherapy (CCRT) and the predictors of the need for PEG.
326 patients with laryngeal, oropharyngeal or hypopharyngeal cancers were retrospectively reviewed.
The PEG tube use group had more favorable results than the total parenteral nutrition and nasogastric tube groups in terms of rate of serum albumin loss, incidence of severe fever and aspiration pneumonia, CCRT completion rate and hospitalization period. However, it was inferior to oral intake. Analysis of the relative risk of requiring enteral or parenteral nutrition revealed that performance status (PS) 2, primary site (supraglottis, oropharynx, or hypopharynx), N3 disease, and cisplatin were predictors of the need for nutritional support.
Prophylactic PEG is effective for patients treated with definitive CCRT and is especially required for patients with PS2 or oropharyngeal cancer.
我们研究了预防性经皮内镜下胃造口术（PEG）对接受根治性同步放化疗（CCRT）的患者是否有效，以及PEG需求的预测因素。
对326例喉癌、口咽癌或下咽癌患者进行回顾性分析。
在血清白蛋白丢失率、严重发热和吸入性肺炎发生率、CCRT完成率及住院时间方面，PEG管使用组比全胃肠外营养组和鼻胃管组有更优的结果。然而，其不如经口摄入。对肠内或肠外营养需求的相对风险分析显示，体能状态（PS）为2、原发部位（声门上区、口咽或下咽）、N3期疾病及顺铂是营养支持需求的预测因素。
预防性PEG对接受根治性CCRT的患者有效，对于PS2患者或口咽癌患者尤其需要。
