Prophylactic gastrostomy in locally advanced head and neck cancer: results of a national survey among radiation oncologists
Abstract Background Nutritional complications in patients with locally advanced head and neck cancer (LA-HNC) treated by concurrent chemoradiotherapy (CCRT) often lead to placement of a prophylactic gastrostomy (PG) tube, while indication lacks harmonization. Our aim was to explore the current PG tu...
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doaj-ee677df6009145469278016a5abbaa502021-06-06T11:51:47ZengBMCBMC Cancer1471-24072021-06-012111810.1186/s12885-021-08348-9Prophylactic gastrostomy in locally advanced head and neck cancer: results of a national survey among radiation oncologistsTatiana Dragan0Fréderic Duprez1André Van Gossum2Akos Gulyban3Sylvie Beauvois4Antoine Digonnet5Yassine Lalami6Dirk Van Gestel7Department of Radiation Oncology (Head and Neck Unit), Institut Jules Bordet, Université Libre de BruxellesDepartment of Radiotherapy-Oncology, Universitair Ziekenhuis GentConsultant at the Department of Gastroenterology and Clinical Nutrition, Hopital Erasme and Institut Jules BordetMedical Physics Department, Institut Jules BordetDepartment of Radiation Oncology (Head and Neck Unit), Institut Jules Bordet, Université Libre de BruxellesDepartment of Head and Neck Surgery, Institut Jules Bordet, Université Libre de BruxellesMedical Oncology Clinic, Institut Jules Bordet, Université Libre de BruxellesDepartment of Radiation Oncology (Head and Neck Unit), Institut Jules Bordet, Université Libre de BruxellesAbstract Background Nutritional complications in patients with locally advanced head and neck cancer (LA-HNC) treated by concurrent chemoradiotherapy (CCRT) often lead to placement of a prophylactic gastrostomy (PG) tube, while indication lacks harmonization. Our aim was to explore the current PG tube utilization among Belgian radiation oncology centers. Methods A survey was distributed to all 24 Belgian Radiation oncology departments, with questions about the number of patient treated per year, whether the PG indication is discussed at the multidisciplinary board, placement technique, time of starting nutrition and removal, its impact on swallowing function and importance of clinical factors. For the latter Relative Importance and Discordance Indexes were calculated to describe the ranking and agreement. Results All 24 centers submitted the questionnaire. Twenty three treat more than 20 head and neck (HNC) patients per year, while four (1 in 21–50; 3 in 51–100) are not discussing the gastrostomy tube indication at the multidisciplinary board. For the latter, endoscopic placement (68%) is the dominant technique, followed by the radiologic (16%) and laparoscopic (16%) methods. Seventy-five percent start the enteral nutrition when clinically indicated, 17% immediately and 8% from the start of radiotherapy. Majority of specialists (19/24) keep the gastrostomy tube until the patient assume an adequate oral feeding. Fifteen centres are considering PG decrease swallowing function. Regarding factors and their importance in the decision for the PG, foreseen irradiated volume reached highest importance, followed by ‘anatomical site’, ‘patients’ choice’ and ‘postoperative versus definitive’ and ‘local expertise’, with decreasing importance respectively. Disagreement indexes showed moderate variation. Conclusions The use of a PG tube for LAHNC patients treated by CCRT shows disparity at national level. Prospective studies are needed to ensure proper indication of this supportive measure.https://doi.org/10.1186/s12885-021-08348-9Endoscopic gastrostomyHead and neck cancerRadiotherapySurvey |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Tatiana Dragan Fréderic Duprez André Van Gossum Akos Gulyban Sylvie Beauvois Antoine Digonnet Yassine Lalami Dirk Van Gestel |
spellingShingle |
Tatiana Dragan Fréderic Duprez André Van Gossum Akos Gulyban Sylvie Beauvois Antoine Digonnet Yassine Lalami Dirk Van Gestel Prophylactic gastrostomy in locally advanced head and neck cancer: results of a national survey among radiation oncologists BMC Cancer Endoscopic gastrostomy Head and neck cancer Radiotherapy Survey |
author_facet |
Tatiana Dragan Fréderic Duprez André Van Gossum Akos Gulyban Sylvie Beauvois Antoine Digonnet Yassine Lalami Dirk Van Gestel |
author_sort |
Tatiana Dragan |
title |
Prophylactic gastrostomy in locally advanced head and neck cancer: results of a national survey among radiation oncologists |
title_short |
Prophylactic gastrostomy in locally advanced head and neck cancer: results of a national survey among radiation oncologists |
title_full |
Prophylactic gastrostomy in locally advanced head and neck cancer: results of a national survey among radiation oncologists |
title_fullStr |
Prophylactic gastrostomy in locally advanced head and neck cancer: results of a national survey among radiation oncologists |
title_full_unstemmed |
Prophylactic gastrostomy in locally advanced head and neck cancer: results of a national survey among radiation oncologists |
title_sort |
prophylactic gastrostomy in locally advanced head and neck cancer: results of a national survey among radiation oncologists |
publisher |
BMC |
series |
BMC Cancer |
issn |
1471-2407 |
publishDate |
2021-06-01 |
description |
Abstract Background Nutritional complications in patients with locally advanced head and neck cancer (LA-HNC) treated by concurrent chemoradiotherapy (CCRT) often lead to placement of a prophylactic gastrostomy (PG) tube, while indication lacks harmonization. Our aim was to explore the current PG tube utilization among Belgian radiation oncology centers. Methods A survey was distributed to all 24 Belgian Radiation oncology departments, with questions about the number of patient treated per year, whether the PG indication is discussed at the multidisciplinary board, placement technique, time of starting nutrition and removal, its impact on swallowing function and importance of clinical factors. For the latter Relative Importance and Discordance Indexes were calculated to describe the ranking and agreement. Results All 24 centers submitted the questionnaire. Twenty three treat more than 20 head and neck (HNC) patients per year, while four (1 in 21–50; 3 in 51–100) are not discussing the gastrostomy tube indication at the multidisciplinary board. For the latter, endoscopic placement (68%) is the dominant technique, followed by the radiologic (16%) and laparoscopic (16%) methods. Seventy-five percent start the enteral nutrition when clinically indicated, 17% immediately and 8% from the start of radiotherapy. Majority of specialists (19/24) keep the gastrostomy tube until the patient assume an adequate oral feeding. Fifteen centres are considering PG decrease swallowing function. Regarding factors and their importance in the decision for the PG, foreseen irradiated volume reached highest importance, followed by ‘anatomical site’, ‘patients’ choice’ and ‘postoperative versus definitive’ and ‘local expertise’, with decreasing importance respectively. Disagreement indexes showed moderate variation. Conclusions The use of a PG tube for LAHNC patients treated by CCRT shows disparity at national level. Prospective studies are needed to ensure proper indication of this supportive measure. |
topic |
Endoscopic gastrostomy Head and neck cancer Radiotherapy Survey |
url |
https://doi.org/10.1186/s12885-021-08348-9 |
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