Gastrostomy tubes in patients with advanced head and neck cancer

被引:32
作者
Ahmed, EA [1 ]
Samant, S [1 ]
Vieira, F [1 ]
机构
[1] Univ Tennessee, Hlth Sci Ctr, Dept Otolaryngol Head & Neck Surg, Memphis, TN USA
关键词
chemoradiation; head and neck cancer; gastrostomy;
D O I
10.1097/01.mlg.0000150679.60731.bc
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
Objectives: To measure the percentage of patients requiring gastrostomy tubes (G-tubes) and the timing of their placement, in addition to studying whether pretreatment variables (T stage, tumor site, N stage) and intratreatment variables (weight loss during treatment) are valid predictors for the need for G-tube placement. Study Design: Retrospective case control study. Methods: Retrospective review of a prospectively collected database with chart reviews was carried out on 477 patients treated on a regimen of intraarterial cisplatin and concurrent radiation. The likelihood of requiring a G-tube was calculated by studying several independent variables using chi-square analysis and the unpaired t test. Results: Two hundred twenty (46%) patients had G-tubes placed, with mean time of placement being on day 20 after the initiation of treatment. Patients with T4 disease were statistically more likely to require a G-tube (50% vs. 37%, P <.05). Patients were less likely to require a G-tube when the primary site of tumor involved the larynx or paranasal sinuses (P <.05). There were no statistically significant differences between the two groups with regards to patient age, sex, N stage, and weight changes over the course of treatment The odds of requiring a G-tube were highest for tumors involving the hypopharynx (80%), oral cavity (52%), and oropharynx (49%). Conclusions: Although clinical judgment appears to be sufficient for deciding when G-tube placement is warranted in our population, the threshold for placing a tube should be lower in those patients who had a higher likelihood of requiring a G-tube during the course of treatment, including those with advanced disease of the oral cavity, oropharynx, and hypopharynx.
引用
收藏
页码:44 / 47
页数:4
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