Kouka Mussab, Brand Sophie, Koscielny Sven, Bitter Thomas, Pietschmann Klaus, Ernst Thomas, Guntinas-Lichius Orlando
Department of Otorhinolaryngology, Jena University Hospital, 07747 Jena, Germany.
Department of Radiation Oncology, Jena University Hospital, 07747 Jena, Germany.
Cancers (Basel). 2024 Sep 12;16(18):3138. doi: 10.3390/cancers16183138.
This retrospective monocentric cohort study analyzed patients with head and neck cancer according their nutritional status and association of percutaneous endoscopic gastrostomy (PEG) from admission to six months after treatment at a tertiary hospital in Germany from 2017 to 2019. A total of 289 patients (76.5% men; median age 62 years; 63.3% stage IV) were included. Univariate analyses and ANOVAs with repeated measures were performed to analyze differences over time. The percentage of patients requiring PEG was 14.9% (43 of 289 patients) before start of treatment (Z0), 14% (40 of 286 patients alive) after one week (Z1), 22.7% (58 of 255 patients) after six weeks (Z2) and 23% (53 of 230 patients) after six months (Z3) from the end of treatment. PEG placement was associated with alcohol or nicotine consumption, in oropharyngeal and hypopharyngeal carcinoma, squamous cell carcinoma, cancer stage III/IV, chemotherapy and impairment of food intake (all < 0.05). Weight loss between Z1 and Z3 with PEG did not differ from patients without PEG at Z0 ( = 0.074), although patients with PEG at Z0 had a lower mean weight at the beginning. PEG was important for a quarter of the patients alive at Z3 and helped to prevent weight loss.
这项回顾性单中心队列研究分析了2017年至2019年在德国一家三级医院就诊的头颈癌患者，根据其营养状况以及经皮内镜下胃造口术（PEG）从入院到治疗后六个月的情况进行分析。共纳入289例患者（男性占76.5%；中位年龄62岁；63.3%为IV期）。采用单因素分析和重复测量方差分析来分析随时间的差异。在治疗开始前（Z0），需要PEG的患者比例为14.9%（289例患者中的43例），治疗一周后（Z1）为14%（286例存活患者中的40例），六周后（Z2）为22.7%（255例患者中的58例），治疗结束后六个月（Z3）为23%（230例患者中的53例）。PEG置入与饮酒或吸烟、口咽和下咽癌、鳞状细胞癌、癌症III/IV期、化疗以及食物摄入受损均有关（所有P<0.05）。Z1至Z3期间接受PEG治疗的患者体重减轻情况与Z0时未接受PEG治疗的患者无差异（P = 0.074），尽管Z0时接受PEG治疗的患者初始平均体重较低。对于Z3时存活的四分之一患者，PEG很重要，有助于防止体重减轻。
