Enteral nutrition and quality of life in patients undergoing chemoradiotherapy for esophageal carcinoma: a comparison of nasogastric tube, esophageal stent, and ostomy tube feeding - 21/06/18
Abstract |
Background and Aims |
This study prospectively recruited esophageal squamous cell carcinoma patients who received esophageal stent, nasogastric tube (NGT), or jejunostomy/gastrostomy feeding to compare the changes in nutritional status and quality of life during chemoradiation therapy (CRT).
Methods |
In total, 81 patients were analyzed (stent, 7; surgical ostomy, 26; NGT, 19; oral intake, 29). An NGT was inserted when, despite medication, dysphagia or pain worsened with oral feeding during CRT. Serial body weight and daily narcotic demand were recorded. Changes in serum albumin level and quality of life were also assessed. In subgroup analysis comparing NGT and prophylactic surgical ostomy feeding, 5 patients with total occlusion in the ostomy group were excluded.
Results |
Patients in all groups had similar decreases in mean body weight with an overall change of –6.41% ± 5.21% at the end of CRT. The stent group had significantly worse pain, decreased albumin (–1.03 ± .9 mg/dL), and decreased quality of life across CRT compared with the other groups. In subgroup analysis the stent group had significantly higher weight loss, whereas the NGT group had higher narcotic demand and slightly worse quality of life. Two patients (7.7%) had ileus days after jejunostomy creation. Five patients (23.8%) among those received prophylactic ostomy creation and scarcely used it.
Conclusions |
These preliminary results raise concerns that use of esophageal stents may be less suitable in patients undergoing CRT. Tube feeding by means of transnasal or percutaneous routes appear to be comparably effective during CRT, but both have advantages and disadvantages. We suggest a careful endoscopic evaluation to select the population more appropriate for NGT feeding on an as-needed basis during CRT.
Le texte complet de cet article est disponible en PDF.Graphical abstract |
Abbreviations : ANOVA, CRT, ESCC, NGT, QoL, SEMS
Plan
DISCLOSURE: All authors disclosed no financial relationships relevant to this publication. Research support for this study was provided to Dr. I-Chen Wu by the Taiwan Ministry of Science and Technology (grant no. MOST 105-2314-B-037-019-MY3), Kaohsiung Medical University Hospital (grant no. KMUH105-5R01), and Kaohsiung Medical University (KMU-KMUH Co-project of Key Research, grant no. KMU-DK 107008). |
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See CME section, p. 159. |
Vol 88 - N° 1
P. 21 - juillet 2018 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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