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Supporting HPV+ Radical Oropharyngeal patients – How are we managing enteral feeding?


Authors: A Nolan, K Higgins
Publication: Journal of The Irish Head and Neck Society - 2024
Issue: 2 Volume: 2
Published: June, 2024 View PDF

Often patients undergoing radical chemoradiation require enteral feeding (EN). A home NG service was introduced in 2016 so it was timely to audit the target group of this initiative.

Every radical HPV+ Oropharyngeal (HPV+OPX) referral to dietetics and SLT in 2022 was included in this audit. Data gathered included staging, treatment, weights, eating ability (FOIS), enteral nutrition provision, kcal intake and follow up nutritional impact symptoms.

45 HPV+OPX patients were identified. Median time of first dietetic review was 6/35#. 20 patients required enteral feeding during their treatment. Of these, 17 were NG fed, with 2 of these progressing to gastrostomy tubes. There were 3 prophylactic tubes. 6 of the 17 were home NG patients, 11 were admitted for NG feeding.

Of those requiring NG feeding, the median time of placement was 29/35#, with a median of 22 days on feed. Interestingly, the median weight loss from start to end of RT was 6.4kg/7.2% in the non EN group versus 8.2kg/10.1% in the EN group.

This data suggests that there may be a case for earlier dietetic intervention – both in terms of prevention of weight loss and the offer of a home NG before inpatient admission becomes unavoidable medically.

A Nolan1, K Higgins2

1 Department of Nutrition & Dietetics, St. Luke’s Oncology Radiation Network, Dublin

2 Department of Speech & Language Therapy, St. Luke’s Oncology Radiation Network, Dublin

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