Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, 510060, China.
Eur J Clin Nutr. 2022 Nov;76(11):1536-1541. doi: 10.1038/s41430-022-01154-x. Epub 2022 May 9.
We aimed to identify which enteral feeding method was most beneficial for patients and compare clinical outcomes, quality of life, and complication rates by assessing patients who underwent prophylactic percutaneous endoscopic gastrostomy (pPEG) tube, reactive percutaneous endoscopic gastrostomy (rPEG) tube or reactive nasogastric tube (rNGT) insertion.
Patients with head and neck cancers (HNCs) were enrolled between April 1, 2013 and April 17, 2019 (n = 335; 296 males, 39 females). Data concerning patient characteristics and treatment modalities were extracted from the medical records. Comparisons between enteral feeding methods were made by univariate and multivariate analysis. Overall survival (OS) outcomes were analyzed by the log rank test using the Kaplan-Meier method.
A total of 335 patients were included. The median follow-up time was 29.5 months. There were forty-six patients in the pPEG tube group, 23 patients in the rPEG tube group, and 266 patients in the rNGT group. pPEG, increased body-mass index (BMI), and N0-1 category were significantly associated with less weight loss in the multivariate analysis (all P < 0.05). pPEG decreased the rate of radiotherapy delay compared with that of reactive interventions (23.1% vs. 47.1%, P = 0.007). In terms of quality of life, global health status, role functioning, emotional functioning, cognitive functioning, pain, and dyspnea were significantly improved in the pPEG tube group (all P < 0.05). BMI and weight loss were independent prognostic factors for clinical survival outcomes (all P < 0.05).
pPEG could improve nutrition outcomes, reduce treatment delay, and maintain quality of life.
我们旨在通过评估接受预防性经皮内镜胃造口术（pPEG）管、反应性经皮内镜胃造口术（rPEG）管或反应性鼻胃管（rNGT）插入的患者，确定哪种肠内喂养方法对患者最有益，并比较临床结局、生活质量和并发症发生率。
2013 年 4 月 1 日至 2019 年 4 月 17 日期间，共纳入 335 例头颈部癌症（HNC）患者（296 例男性，39 例女性）。从病历中提取患者特征和治疗方式的数据。通过单变量和多变量分析比较肠内喂养方法。采用对数秩检验和 Kaplan-Meier 法分析总生存（OS）结果。
共纳入 335 例患者，中位随访时间为 29.5 个月。pPEG 管组 46 例，rPEG 管组 23 例，rNGT 组 266 例。多变量分析显示，pPEG、体重指数（BMI）增加和 N0-1 期与体重减轻减少显著相关（均 P<0.05）。与反应性干预相比，pPEG 可降低放疗延迟率（23.1% vs. 47.1%，P=0.007）。在生活质量方面，pPEG 组的总体健康状况、角色功能、情感功能、认知功能、疼痛和呼吸困难均显著改善（均 P<0.05）。BMI 和体重减轻是临床生存结局的独立预后因素（均 P<0.05）。
pPEG 可改善营养结局、减少治疗延迟并维持生活质量。
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