Xiao Jenny B, Cherukupalli Abhiram, Tran Khanh Linh, Prisman Eitan
Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Division of Otolaryngology Head and Neck Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada.
Head Neck. 2025 Mar;47(3):1006-1017. doi: 10.1002/hed.28010. Epub 2024 Nov 25.
Malnutrition is a major problem in head and neck cancer (HNC) with up to half of patients requiring gastrostomy tube (G-tube) placement. Predicting this need remains complex given mixed evidence surrounding its usage.
A comprehensive search was performed to identify studies examining risk factors associated with G-tube placement following radiotherapy (RT) or concurrent chemoradiotherapy (CCRT) in HNC patients.
Sixteen retrospective studies were included (n = 11 015). The overall prevalence of G-tube placement was 44% with 76% of patients receiving reactive G-tube placement. Pretreatment dysphagia, pretreatment BMI < 18.5, and tumors in the hypopharynx were significant predictive factors for prophylactic G-tube placement. Type of chemotherapy regimen, tumors in the nasopharynx, and cytokine changes were significant predictive factors for reactive G-tube placement.
Several factors were identified that contribute to increased risk of G-tube placement and may guide current decision-making algorithms.
营养不良是头颈癌（HNC）的一个主要问题，多达一半的患者需要放置胃造瘘管（G管）。鉴于围绕其使用的证据不一，预测这种需求仍然很复杂。
进行了全面检索，以确定研究头颈癌患者放疗（RT）或同步放化疗（CCRT）后与放置G管相关的危险因素的研究。
纳入了16项回顾性研究（n = 11015）。G管放置的总体患病率为44%，76%的患者接受了反应性G管放置。治疗前吞咽困难、治疗前体重指数（BMI）<18.5以及下咽肿瘤是预防性G管放置的重要预测因素。化疗方案类型、鼻咽部肿瘤和细胞因子变化是反应性G管放置的重要预测因素。
确定了几个导致G管放置风险增加的因素，这些因素可能指导当前的决策算法。
