Hearne B E, Dunaj J M, Daly J M, Strong E W, Vikram B, LePorte B J, DeCosse J J
J Am Diet Assoc. 1985 Jun;85(6):669-74, 677.
This comparison of tube feeding with oral nutrition was made in patients with advanced head and neck cancer during intensive outpatient radiation therapy. Twenty-six patients with Stage III and IV head and neck cancers were stratified by site (nasopharynx vs. all other tumors, including recurrent nasopharynx) and randomized to receive oral or tube feeding during radiation therapy. All patients were counseled to have an intake of 40 kcal/kg and 1 gm protein per kilogram body weight. Body weights and dietary recalls were obtained weekly, along with evaluation of toxicities to therapy. Serum albumins were obtained at baseline, week 4, end of radiation therapy, and 1 month after radiation therapy. Patients with nasopharyngeal carcinoma presented with significantly less body weight loss (means = -2.6%) than patients with all other carcinomas (means = -9.8%; p = .008). No differences in toxic responses were observed despite larger radiation field size in the tube-fed group (p = .02). Serum albumins in both groups dropped during radiation therapy, with no difference between groups. The tube-fed group maintained higher caloric and protein intakes (35 to 42 kcal/kg, 1.2 to 1.6 gm protein per kilogram) than the oral-fed group (15 to 34 kcal/kg, 0.3 to 1.3 gm protein per kilogram). No differences in body weights were observed between the tube-fed (means = 3.8%) and the oral-fed (means = 3.3%) patients with nasopharyngeal carcinoma. Patients with oropharyngeal and recurrent nasopharyngeal carcinoma had significantly less weight loss with tube feeding (means = 0.2%) than with oral feeding (means = -7.3%; p = .005); thus, tube feeding is recommended during radiation therapy in such patients.
在晚期头颈癌患者接受强化门诊放疗期间，对管饲营养与口服营养进行了比较。26例III期和IV期头颈癌患者按部位（鼻咽癌与所有其他肿瘤，包括复发性鼻咽癌）分层，并随机分为在放疗期间接受口服或管饲营养。所有患者均被告知摄入40千卡/千克和每千克体重1克蛋白质。每周记录体重和饮食回顾情况，并评估治疗毒性。在基线、第4周、放疗结束时以及放疗后1个月采集血清白蛋白。鼻咽癌患者的体重减轻明显少于所有其他癌症患者（平均值分别为-2.6%和-9.8%；p = 0.008）。尽管管饲组的放疗野面积更大，但两组的毒性反应无差异（p = 0.02）。放疗期间两组的血清白蛋白均下降，组间无差异。管饲组的热量和蛋白质摄入量（35至42千卡/千克，每千克1.2至1.6克蛋白质）高于口服组（15至34千卡/千克，每千克0.3至1.3克蛋白质）。鼻咽癌的管饲患者（平均值 = 3.8%）和口服患者（平均值 = 3.3%）之间的体重无差异。口咽癌和复发性鼻咽癌患者管饲时的体重减轻（平均值 = 0.2%）明显少于口服时（平均值 = -7.3%；p = 0.005）；因此，建议此类患者在放疗期间采用管饲营养。
