Head and neck cancer (HNC) patients often struggle to meet their nutritional needs, necessitating the use of enteral nutrition.
This study aimed to evaluate current evidence regarding the impact of prophylactic versus reactive tube placement on patient outcomes in adult HNC patients.
A rapid review was conducted. Two researchers searched PubMed and EMBASE and independently reviewed the manuscripts against the eligibility criteria and quality assessment tools.
35 papers were included for data extraction. Over half of the studies found that patients with a prophylactic gastrostomy (P-GT) experienced significantly less weight loss than those with a reactive gastrostomy (R-GT) or no gastrostomy (N-GT). The majority (60%) of studies that compared the complication rate of P-GT to N-GT/R-GT found no significant difference. Prophylactic tube placement was linked to fewer treatment interruptions, delays, and unplanned hospitalizations compared to R-GT. No study found P-GT impacting survival, while half reported no significant difference in quality-of-life outcomes. No significant differences in tube dependency rates and swallow function between tube timing approaches was found.
The ongoing debate reflects the mixed results obtained. Ultimately, decisions surrounding tube placement timing should be assessed on a case-by-case basis by the multidisciplinary team, involving the patient in the decision-making process.
Edel Dillon¹, Sarah Miller¹, Niamh Lucey³, Diarmaid Stokes¹, Oonagh Griffin¹,²
1 School of Public Health, Physiotherapy & Sports Science, University College Dublin, Dublin
2 Department of Nutrition & Dietetics, St. Vincent’s University Hospital, Dublin