Validation of an updated evidence-based protocol for proactive gastrostomy tube insertion in patients with head and neck cancer

被引：19

作者：

Brown, T. E. ^{[1
,2
]}

Getliffe, V. ^{[2
]}

Banks, M. D. ^{[1
]}

Hughes, B. G. M. ^{[3
,4
]}

Lin, C. Y. ^{[3
]}

Kenny, L. M. ^{[3
]}

Bauer, J. D. ^{[2
]}

机构：

[1] Royal Brisbane & Womens Hosp, Dept Nutr & Dietet, Level 2,James Mayne Bldg,Butterfield St, Brisbane, Qld 4029, Australia

[2] Univ Queensland, Sch Human Movement Studies, Ctr Dietet Res C DIET R, Brisbane, Qld, Australia

[3] Royal Brisbane & Womens Hosp, Canc Care Serv, Brisbane, Qld 4029, Australia

[4] Univ Queensland, Sch Med, Brisbane, Qld, Australia

来源：

EUROPEAN JOURNAL OF CLINICAL NUTRITION | 2016年 / 70卷 / 05期

关键词：

PERCUTANEOUS ENDOSCOPIC GASTROSTOMY; INTENSITY-MODULATED RADIOTHERAPY; QUALITY-OF-LIFE; OROPHARYNGEAL CANCER; HUMAN-PAPILLOMAVIRUS; HELICAL TOMOTHERAPY; RADIATION-THERAPY; PROPHYLACTIC GASTROSTOMY; ADAPTIVE RADIOTHERAPY; WEIGHT-LOSS;

D O I：

10.1038/ejcn.2015.230

中图分类号：

R15 [营养卫生、食品卫生]; TS201 [基础科学];

学科分类号：

100403 ;

摘要：

BACKGROUND/OBJECTIVES: Evidence-based practice guidelines are available to assist in the decision making for nutrition interventions in patients with head and neck cancer. Re-assessment of guideline recommendations is important with changing demographics, new treatment regimens, advancing radiotherapy techniques, such as helical intensity-modulated radiotherapy, and the emergence of new literature. The aim of this study was to validate the updated high-risk category definition in our local hospital protocol for the swallowing and nutrition management of patients with head and neck cancer to determine the ongoing predictive ability for identifying proactive gastrostomy requirement in a new cohort. SUBJECTS/METHODS: Patients attending a major tertiary hospital for head and neck cancer treatment from 2010 to 2011 were included (n = 270). Data were collected on patient demographics (age and gender), clinical factors (tumour site, staging and treatment), nutrition outcome measures (weight, enteral feeding) and protocol adherence. Sensitivity and specificity were calculated and compared with the original validation study. RESULTS: Proactive gastrostomy tubes were inserted in 86 patients. Overall protocol adherence was 93%. Sensitivity improved to 72% (increase of 18%) and specificity improved to 96% (increase of 3%) compared with the original validation study where patients received three-dimensional (3-D) conformal radiotherapy. CONCLUSIONS: The results of this study confirm that the updated high-risk category in the protocol for the swallowing and nutrition management of patients with head and neck cancer remains valid to predict proactive gastrostomy in a mixed population receiving helical intensity-modulated radiotherapy and 3-D conformal radiotherapy. The protocol has an improved sensitivity and specificity and hence remains just as relevant for advanced techniques of radiation treatment delivery.

引用

页码：574 / 581

页数：8

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